Abstract
ABSTRACTObjective: To discuss the predictive value of the General Movements Assessment for the diagnosis of neurodevelopment disorders in preterm newborns.Data source: We conducted a systematic literature review using the following databases: Scientific Electronic Library Online (SciELO), National Library of Medicine, National Institutes of Health (PubMed), and Excerpta Medica Database (EMBASE). The articles were filtered by language, year of publication, population of interest, use of Prechtl’s Method on the Qualitative Assessment of General Movements, and presence of variables related to the predictive value. The Quality Assessment of Diagnostic Accuracy Studies 2 was used to assess the methodology of the included studies. Sensitivity, specificity, Diagnostic Odds Ratio, positive and negative likelihood ratio, and parameter of accuracy were calculated.Data synthesis: Six of 342 articles were included. The evaluation of Writhing Movements is a good indicator for recognizing cerebral palsy, as it has high values for the sensitivity and accuracy parameters. The evaluation of Fidgety Movements has the strongest predictive validity for cerebral palsy, as it has high values in all measures of diagnostic accuracy. The quality assessment shows high risk of bias for patient selection and flow and timing of the evaluation. Therefore, the scale has potential to detect individuals with neurodevelopment disorders. However, the studies presented limitations regarding the selection of subjects and the assessment of neurological outcomes.Conclusions: Despite the high predictive values of the tool to identify neurological disorders, research on the subject is required due to the heterogeneity of the current studies.
Highlights
The survival of increasingly premature newborns has become a matter of concern, as preterm infants are known to have an increased risk for neurodevelopmental disorders.[1]
Diagnosis of neurodevelopmental changes is essential for planning interventions that promote adequate growth and development of preterm infants, attenuate complications resulting from brain injury, and improve the child’s future functionality
Exclusion criteria were: review articles, abstracts published at events or poster presentations, editorials, and articles published in full that did not describe the predictive values of sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV)
Summary
The survival of increasingly premature newborns has become a matter of concern, as preterm infants are known to have an increased risk for neurodevelopmental disorders.[1] The incidence of morbidity, including cerebral palsy (CP), remains high and worrisome.[2,3,4,5]. Diagnosis of neurodevelopmental changes is essential for planning interventions that promote adequate growth and development of preterm infants, attenuate complications resulting from brain injury, and improve the child’s future functionality. Some factors may influence the performance of preterm infants when they undergo certain tests, as they are clinically fragile and may be unable to maintain sufficient energy reserves to produce the best results throughout the evaluation.[6,9,10]
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