A comparison of the early motor repertoire of very preterm infants and term infants

Salavati, Sahar; Berghuis, Sietske A.; Bosch, Tess; Hitzert, Marrit M.; Baptist, Dyvonne H.; Mebius, Mirthe J; Bos, Arend F.

doi:10.1016/j.ejpn.2021.03.014

Cited by 14 publications

(24 citation statements)

References 28 publications

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“…In our study, in both groups, the most common score was in the "mildly reduced" range, which means a score between 20 and 24, most likely due to prematurity. This corresponds to the results of Salavati et al, 2021. In this study 180 very preterm and 180 healthy term infants participated.…”

Section: Discussionsupporting

confidence: 84%

“…These include BPD, sepsis, and hypoglycemia each of which may lead to impaired neurodevelopment and cognition (57)(58)(59). As discussed above, preterm birth is itself a risk for worse outcome in the MOS-R (47). Another limitation is partly incomplete existence of videos due to the following: Video analysis of motor function at 3 months of age was only gradually introduced in follow-up care from 2017.…”

Section: Discussionmentioning

confidence: 99%

“…In this study 180 very preterm and 180 healthy term infants participated. The median MOS-R scores of very preterm infants were significantly lower in comparison to those of term infants, with scores of 24 (25th-75th percentiles: 23-26) and 26 (25th-75th percentiles: 26-28), respectively ( 47 ).…”

Section: Discussionmentioning

confidence: 99%

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The Impact of Increased Maternal sFlt-1/PlGF Ratio on Motor Outcome of Preterm Infants

et al. 2022

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BackgroundThe sFlt-1 (soluble fms-like tyrosine kinase-1)/PlGF (placental growth factor) ratio serves as a clinical biomarker to predict the hypertensive, placenta-derived pregnancy disorder pre-eclampsia which is often associated with placental dysfunction and fetal growth restriction. Additionally elevated levels also indicate an increased risk for prematurity. However, its predictive value for subsequent neonatal neurological outcome has not been studied.ObjectiveThis study aimed to evaluate the correlation of maternal sFlt-1/PlGF ratio with early motor outcome of preterm infants. Design/Methods: 88 preterm infants (gestational age ≤ 34 + 0) born between February 2017 and August 2020 at the Department of Obstetrics and Gynecology, University Hospital Essen in Germany, were included, when the following variables were available: maternal sFlt-1/PlGF levels at parturition and general movement assessment of the infant at the corrected age of 3 to 5 months. The infants were stratified into high and low ratio groups according to maternal sFlt-1/PlGF cut-off values of 85. To investigate the early motor repertoire and quality of spontaneous movements of the infant, the Motor Optimality Score (MOS-R) based on antigravity movements and posture patterns, was applied. In the given age, special attention was paid to the presence of fidgety movements. Linear regressions were run to test differences in infants motor repertoire according to the maternal sFlt-1/PIGF ratio.ResultsLinear regression analysis showed that the sFlt-1/PlGF ratio does not predict the MOS-R score (β=≤0.001; p=0.282). However, children with birth weight below the 10th percentile scored significantly lower (mean 20.7 vs 22.7; p=0.035). These children were 91% in the group with an increased ratio, which in turn is a known predictor of low birth weight (β= -0.315; p <0.001). In the group with a high sFlt-1/PLGF ratio above 85 the mothers of female infants had a lower average sFlt-1/PlGF ratio compared to a male infant (median: 438 in female vs. 603 in male infant, p=0.145).ConclusionsIn our cohort, especially low birth weight, which correlated with an elevated sFlt-1/PlGF ratio, had a negative effect on the outcome in the MOS-R. A direct correlation between an increased ratio and a worse motor outcome was not demonstrated.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

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The Impact of Increased Maternal sFlt-1/PlGF Ratio on Motor Outcome of Preterm Infants

et al. 2022

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“…16 Existing prospective cohort studies of very low birthweight infants have found that higher motor optimality scores are associated with better motor function at 1 year 17 and with cognitive, language and motor development of very preterm infants at 2 years. 18 Recent studies have identified median MOS-R between 24 and 26 for infants born at term, [19][20][21][22][23] and a study investigating the difference in infants born EP with adverse outcomes found lower median MOS-R (17.5) compared with infants born EP with a normal outcome (median MOS- R 21). 24 To our knowledge, no studies have documented typical MOS-R scored from…”

Section: While Fidgety Movements Have Good Predictive Validitymentioning

confidence: 99%

Parent‐recorded videos of infant spontaneous movement: Comparisons at 3–4 months and relationships with 2‐year developmental outcomes in extremely preterm, extremely low birthweight and term‐born infants

Kwong

Doyle

Olsen

et al. 2022

Paediatric Perinatal Epid

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Background: Infants born extremely preterm (EP, <28-week gestational age) or extremely low birthweight (ELBW, <1000 g) are at risk of developmental delay and cerebral palsy (CP). The General Movements Assessment (GMA) and its extension, the Motor Optimality Score, revised (MOS-R) (assesses movement patterns and posture), may help to identify early delays.Objectives: To compare differences in the MOS-R scored from parent-recorded videos between infants born EP/ELBW and term-born infants, to determine relationships between the MOS-R and 2-year cognitive, language and motor outcomes and if any relationships differ between birth groups and the association of the GMA (fidgety) with CP.Methods: A geographical cohort (EP/ELBW and term-control infants) was assessed using the MOS-R inclusive of the GMA at 3-to 4-month corrected age (CA), and the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III) at 2-year CA. Differences in mean total MOS-R between groups, relationships between MOS-R and 2-year outcomes and relationships between GMA (fidgety) and CP in infants born EP/ELBW were estimated using linear/logistic regression.Results: Three hundred and twelve infants (147 EP/ELBW; 165 term) had complete MOS-R and Bayley-III assessments. Mean MOS-R was lower in infants born EP/ELBW than controls (mean difference −3.2, 95% confidence interval [CI] −4.2, −2.3). MOS-R was positively related to cognitive (β [regression coefficient] = 0.71, 95% CI 0.27, 1.15), language (β = 0.96, 95% CI 0.38, 1.54) and motor outcomes (β = .89, 95% CI 0.45, 1.34). There was little evidence for interaction effects between birth groups for any outcome. Absent/abnormal fidgety movements were related to CP in children born EP/ELBW (risk ratio 5.91, 95% CI 1.48, 23.7).Conclusions: Infants born EP/ELBW have lower MOS-R than infants born at term.

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“…A method to reliably assess early neurological functioning is by assessing the early motor repertoire of infants. At 9–16 weeks post-term, the early motor repertoire includes fidgety movements (FMs), small circular movements visible in all joints ( 13 ), as well as several other movement and postural patterns, which together form the basis for the motor optimality score – revised (MOS-R) ( 14 ). The early motor repertoire, including the MOS-R, is reported to be predictive of cerebral palsy (CP).…”

Section: Introductionmentioning

confidence: 99%

Differential Placental DNA Methylation of NR3C1 in Extremely Preterm Infants With Poorer Neurological Functioning

et al. 2022

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BackgroundUnderstanding underlying mechanisms of neurodevelopmental impairment following preterm birth may enhance opportunities for targeted interventions. We aimed to assess whether placental DNA methylation of selected genes affected early neurological functioning in preterm infants.MethodsWe included 43 infants, with gestational age <30 weeks and/or birth weight <1,000 g and placental samples at birth. We selected genes based on their associations with several prenatal conditions that may be related to poor neurodevelopmental outcomes. We determined DNA methylation using pyrosequencing, and neurological functioning at 3 months post-term using Prechtl's General Movement Assessment, including the Motor Optimality Score-Revised (MOS-R).ResultsTwenty-four infants had atypical MOS-R, 19 infants had near-optimal MOS-R. We identified differences in average methylation of NR3C1 (encoding for the glucocorticoid receptor) [3.3% (95%-CI: 2.4%−3.9%) for near-optimal vs. 2.3% (95%-CI: 1.7%−3.0%), p = 0.008 for atypical], and at three of the five individual CpG-sites. For EPO, SLC6A3, TLR4, VEGFA, LEP and HSD11B2 we found no differences between the groups.ConclusionHypomethylation of NR3C1 in placental tissue is associated with poorer neurological functioning at 3 months post-term in extremely preterm infants. Alleviating stress during pregnancy and its impact on preterm infants and their neurodevelopmental outcomes should be further investigated.

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A comparison of the early motor repertoire of very preterm infants and term infants

Cited by 14 publications

References 28 publications

The Impact of Increased Maternal sFlt-1/PlGF Ratio on Motor Outcome of Preterm Infants

The Impact of Increased Maternal sFlt-1/PlGF Ratio on Motor Outcome of Preterm Infants

Parent‐recorded videos of infant spontaneous movement: Comparisons at 3–4 months and relationships with 2‐year developmental outcomes in extremely preterm, extremely low birthweight and term‐born infants

Differential Placental DNA Methylation of NR3C1 in Extremely Preterm Infants With Poorer Neurological Functioning

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