Does general movements quality in term infants predict cerebral palsy and milder forms of limited mobility at 6 years?

• Published in: Developmental medicine and child neurology Vol. 58; no. 12; pp. 1310 - 1316
• Main Authors: Iersel, Patricia A M, Bakker, Saskia C M, Jonker, Arnold J H, Hadders‐Algra, Mijna
• Format: Journal Article
• Language: English
• Published: England 01.12.2016
• Subjects: Cerebral Palsy - diagnosis; Child; Female; Humans; Infant; Infant Behavior - physiology; Infant, Newborn; Male; Mobility Limitation; Motor Activity - physiology; Prognosis; Prospective Studies; Sensitivity and Specificity; Severity of Illness Index
• ISSN: 0012-1622; 1469-8749
• DOI: 10.1111/dmcn.13228

Aim To evaluate in term infants associations between quality of general movements and developmental outcome in term infants at 6 years with either cerebral palsy (CP) or limited mobility without CP. Method Participants of this prospective study were 145 term infants (86 male, 59 female). Their general movements quality was assessed at ‘writhing’ and ‘fidgety’ general movements age (3wks and 13wks post term). The assessment at 6 years consisted of a neurological examination, including assessment of minor neurological dysfunction (MND), evaluation of mobility with the Movement Assessment Battery for Children, and of behaviour and learning problems with questionnaires. Results Definitely abnormal general movements at writhing age were not associated with CP, whereas definitely abnormal general movements at fidgety age were (sensitivity 60%; specificity 91%; positive predictive value 19%, negative predictive value 98%). In children without CP, general movements quality was not associated with limited mobility, but it was associated to a minor extent with MND. Interpretation In term infants, definitely abnormal general movements at fidgety age do predict CP, but with lower accuracy than in preterm infants. General movements quality does not predict limited mobility in children without CP. The study supports suggestions that predictive value of general movements assessment in term infants is lower than that in preterm infants. What this paper adds Definitely abnormal general movements at fidgety general movements age predict cerebral palsy (CP) in term infants with lower accuracy than in preterm infants. General movements quality of term infants does not predict limited mobility in children without CP. Predictive value of general movements assessment is lower in term infants than in preterm infants.