Fidgety movements in infants born very preterm: predictive value for cerebral palsy in a clinical multicentre setting.
- Datta AN Division of Neuropediatrics and Developmental Medicine, University of Basel Children's Hospital, Basel, Switzerland.
- Furrer MA Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital Bern, Inselspital, Bern University Hospital, Bern, Switzerland.
- Bernhardt I Institute for Physical Therapy, Inselspital, Bern University Hospital, Bern, Switzerland.
- Hüppi PS Department of Development and Growth, University Children's Hospital Geneva, Geneva, Switzerland.
- Borradori-Tolsa C Department of Development and Growth, University Children's Hospital Geneva, Geneva, Switzerland.
- Bucher HU Division of Neonatalology, University Hospital Zurich, Zurich, Switzerland.
- Latal B Child Development Centre, University Children's Hospital Zurich, Zurich, Switzerland.
- Grunt S Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital Bern, Inselspital, Bern University Hospital, Bern, Switzerland.
- Natalucci G Division of Neonatalology, University Hospital Zurich, Zurich, Switzerland.
- 2017-01-20
Published in:
- Developmental medicine and child neurology. - 2017
Cerebral Palsy
Child Development
Child, Preschool
Echoencephalography
Female
Follow-Up Studies
Humans
Infant
Infant, Premature
Male
Movement
Prognosis
Switzerland
English
AIM
This study assessed predictive values of fidgety movement assessment (FMA) in a large sample of infants born very preterm for developmental abnormalities, in particular for cerebral palsy (CP) at 2 years in an everyday clinical setting.
METHOD
This is a multicentre study of infants born preterm with gestational age lower than 32.0 weeks. FMA was performed at 3 months corrected age; neurodevelopment (Bayley Scales of Infant Development, 2nd edition) and neurological abnormalities were assessed at 2 years. Predictive values of FMA for the development of CP were calculated and combined with abnormalities at cerebral ultrasound.
RESULTS
Five hundred and thirty-five infants (gestational age 28.2wks [standard deviation 1.3wks]) were included. Eighty-one percent showed normal fidgety movements and 19% atypical (82 absent, 21 abnormal) fidgety movements. Absent fidgety movements predicted CP at 2 years with an odds ratio (OR) of 8.9 (95% confidence interval [CI] 4.1-17.0), a combination of atypical fidgety movements and major brain lesion on cerebral ultrasound predicted it with an OR of 17.8 (95% CI 5.2-61.6). Mean mental developmental index of infants with absent fidgety movements was significantly lower (p=0.012) than with normal fidgety movements.
INTERPRETATION
Detection of infants at risk for later CP through FMA was good, but less robust when performed in a routine clinical setting; prediction improved when combined with neonatal cerebral ultrasound.
This study assessed predictive values of fidgety movement assessment (FMA) in a large sample of infants born very preterm for developmental abnormalities, in particular for cerebral palsy (CP) at 2 years in an everyday clinical setting.
METHOD
This is a multicentre study of infants born preterm with gestational age lower than 32.0 weeks. FMA was performed at 3 months corrected age; neurodevelopment (Bayley Scales of Infant Development, 2nd edition) and neurological abnormalities were assessed at 2 years. Predictive values of FMA for the development of CP were calculated and combined with abnormalities at cerebral ultrasound.
RESULTS
Five hundred and thirty-five infants (gestational age 28.2wks [standard deviation 1.3wks]) were included. Eighty-one percent showed normal fidgety movements and 19% atypical (82 absent, 21 abnormal) fidgety movements. Absent fidgety movements predicted CP at 2 years with an odds ratio (OR) of 8.9 (95% confidence interval [CI] 4.1-17.0), a combination of atypical fidgety movements and major brain lesion on cerebral ultrasound predicted it with an OR of 17.8 (95% CI 5.2-61.6). Mean mental developmental index of infants with absent fidgety movements was significantly lower (p=0.012) than with normal fidgety movements.
INTERPRETATION
Detection of infants at risk for later CP through FMA was good, but less robust when performed in a routine clinical setting; prediction improved when combined with neonatal cerebral ultrasound.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1111/dmcn.13386
- PMID 28102574
- Persistent URL
- https://sonar.ch/global/documents/132191
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