Is it possible to predict the infant's neurodevelopmental outcome at 14months of age by means of a single preterm assessment of General Movements?

Abstract

BackgroundIt continues to be a challenge for clinicians to identify preterm infants likely to experience subsequent neurodevelopmental deficits. The Test of Infant Motor Performance (TIMP) and the assessment of spontaneous general movements (GMs) are the only reliable diagnostic and predictive tools for the functionality of the developing nervous system, if applied before term.AimTo determine to what extent singular preterm assessments of motor performance can predict the neurodevelopmental outcome in 14-month olds.MethodsThirty-seven preterm infants born < 34 weeks gestational age were recruited for the study at the NICU of the São Lucas University Hospital, Porto Alegre, RS, Brazil. At 34 weeks, their GMs were assessed; and the Test of Infant Motor Performance (TIMP) was applied. A prospective design was used to examine (A) the association between the GM assessment and the TIMP; and (B) the relation between GMs or the TIMP and the developmental status at 14 months, assessed by means of Alberta Infant Motor Scales (AIMS) and the Pediatric Evaluation of Disability Inventory (PEDI).ResultsNineteen infants (41%) had abnormal GMs; only one scored within the TIMP average range. Hence, GMs and TIMP were not related. Children with cramped-synchronized GMs at 34 weeks preterm had a lower AIMS centile rank than those with poor repertoire or normal GMs. There was a marginal association between cramped-synchronized GMs and a lower PEDI mobility score.ConclusionsA single preterm GM assessment is only fairly to moderately associated with the 14-month motor development. The TIMP is not suitable as a complementary assessment tool at such a young age.

Preterm and term‐equivalent age general movements and 1‐year neurodevelopmental outcomes for infants born before 30 weeks' gestation

“…In the current study, there were stronger associations with the NSMDA and TINE than with the AIMS abnormal cut-off scores. There was little evidence of an association between abnormal GMA and abnormal motor function according to the AIMS cut-off, in contrast to previous findings 23 that a single abnormal GMA at 34 weeks postmenstrual age was moderately associated with AIMS scores below fifth centile at 14 months corrected age. Snider et al 24 reported that a GMA at TEA predicted motor scores on the Peabody Developmental Motor Scales-2, and the AIMS standing scale, but not on other AIMS scales, at 12 months corrected age.…”

“…There are few studies that have examined the relationships between GMA before term, 23 or at TEA, 24,25 and outcome on standardized motor assessments for infants born very preterm. In the current study, there were stronger associations with the NSMDA and TINE than with the AIMS abnormal cut-off scores.…”

Early motor repertoire in very low birth weight infants in India is associated with motor development at one year

“…Studies evaluating whether there are differences in GMs between different ethnic or cultural groups are, to the best of our knowledge, not available. Most studies have been performed in Europe, although more studies are now coming also from Brazil, China, Iran and South Africa (9,(16)(17)(18) . It has further been claimed that GMA studies have a risk for bias because study samples are selected retrospectively, based on available video recordings rather than well-defined high-risk cohorts.…”

Motor Performance of Children With Down Syndrome and Typical Development at 2 to 4 and 26 Months

“…Previous studies have reported that gross motor performance measured by the TIMP in infants born at term or preterm was predictive of gross motor performance assessed by using the Alberta Infant Motor Scale at 12 months 18 and of functional performance measured by the Pediatric Evaluation of Disability Inventory at 14 months. 38 Moderate associations between motor performance of infants born preterm measured by the Bayley-II and later motor outcome have also been reported in a recent meta-analysis. 39 Although a much larger sample would be needed to validate the predictive value of the TIMP for children with DS that were later assessed by using the Bayley-III, the results of this study suggest a role of early skills on later outcome and highlight the sensitivity of the TIMP as a quantitative measure of infant motor performance.…”