Occurrence of and temporal trends in fidgety general movements in infants born extremely preterm/extremely low birthweight and term-born controls

Abstract

BackgroundFidgety general movements have high predictive validity for later cerebral palsy (CP) but their temporal organisation requires further understanding for assessment accuracy. AimsTo describe the occurrence of and temporal trends in fidgety movements, and whether they differ between infants born preterm and at term. Study designCohort study. SubjectsWe assessed 155 EP/ELBW infants and 185 term-born infants born extremely preterm (EP; <28 weeks' gestation) and/or extremely low birthweight (ELBW; <1000 g birthweight) or at term (37–42 weeks' gestation) in the state of Victoria, Australia. Outcome measuresParents of infants submitted up to two videos at 12–13+6 and/or 14–16+6 weeks' corrected age of infants' general movements. Videos were scored using the Prechtl General Movements Assessment (GMA) (fidgety) and classified as normal or absent/abnormal. Infants with at least one normal GMA were classified as normal. Individual GMA trajectories were analysed over time using logistic regression. ResultsOverall, infants born EP/ELBW were more likely to have absent/abnormal fidgety movements than term-born infants (23% versus 3%, odds ratio [OR] 8.50 (95% confidence interval (CI) 3.48–20.8, p < 0.001). Fewer EP/ELBW and term-born infants showed absent/abnormal fidgety movements with each week of increasing age (EP/ELBW OR 0.46, 95% CI 0.25–0.84, p = 0.01; term-born OR 0.35, 95% CI 0.16–0.8, p = 0.01; interaction, p = 0.53). ConclusionsAbsent/abnormal fidgety movements are more prevalent in infants born EP/ELBW than at term. Fidgety movements normalise with older age in both infants born EP/ELBW and at term between 12 and 16+6 weeks' corrected age.