Poor repertoire General Movements predict some aspects of development outcome at 2 years in very preterm infants

Abstract

BackgroundObservation of the quality of endogenously generated “General Movements” has been proved to be a reliable and sensitive tool in the assessment of fragile neonates. The absence of fidgety movements at 2–4months post-term is highly predictive of Cerebral Palsy. On the contrary, the presence of a poor repertoire pattern during the writhing period is not reliable in predicting motor or neurobehavioral disorders at any stage of development. AimTo examine if the presence of a PR pattern at 1month post-term was associated with lower neurodevelopmental quotients at 2years. Study designGeneral Movements evaluation at 1 and 3months and the Griffiths Scales of Mental Development at 2years were administered to a sample of very preterm infants. Infants were divided into two groups: poor repertoire pattern group and normal pattern group. Student's t Test and Chi squared test and ANOVA were used to compare neonatal variables and results between the two groups. Subjects79 very preterm infants (birthweight≤1500g or gestational age≤32weeks), born January 2003 to December 2006 who had a follow-up at 2years. Outcome measureGriffiths developmental quotient at 2years. ResultsThe Poor Repertoire group had lower Gestational Age, lower Birth Weight, lower Apgar scores at birth and lower Developmental Quotient at 2years. Eye and Hand Coordination (subscale D) was the domain mostly responsible for such a difference. Quality of fidgety movements (normal or abnormal fidgety) at 3months did not show any correlation with outcome measures at 2years. ConclusionThe presence of a PR pattern at 1month post-term seems to predict lower neurodevelopmental scores at 2years especially in the domain of eye and hand coordination. Longer follow-up is necessary in order to ascertain if such difference will continue to persist at older ages.