High prevalence of abnormal motor repertoire at 3 months corrected age in extremely preterm infants

Toril Fjørtoft; Kari Anne I Evensen; Gunn Kristin Øberg; Nils Thomas Songstad; Cathrine Labori; Inger Elisabeth Silberg; Marianne Loennecken; Unn Inger Møinichen; Randi Vågen; Ragnhild Støen; Lars Adde

doi:10.1016/j.ejpn.2015.12.009

High prevalence of abnormal motor repertoire at 3 months corrected age in extremely preterm infants

Eur J Paediatr Neurol. 2016 Mar;20(2):236-242. doi: 10.1016/j.ejpn.2015.12.009. Epub 2015 Dec 30.

Affiliations

¹ Dept. of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Norway; Dept. of Lab. Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway. Electronic address: toril.fjortoft@ntnu.no.
² Dept. of Lab. Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Dept. of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway; Dept. of Physiotherapy, Trondheim Municipality, Norway.
³ Department of Health and Care Sciences, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway.
⁴ Department of Pediatrics, University Hospital of Northern Norway, Tromsø, Norway.
⁵ Women and Children's Clinic, Neonatal Intensive Care Unit, Oslo University Hospital, Oslo, Norway.
⁶ Women and Children's Clinic, Department of Paediatric Medicine, Oslo University Hospital, Oslo, Norway.
⁷ Dept. of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Norway.
⁸ Dept. of Lab. Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
⁹ Dept. of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Norway; Dept. of Lab. Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.

PMID: 26786751
DOI: 10.1016/j.ejpn.2015.12.009

Abstract

Aims: To compare early motor repertoire between extremely preterm and term-born infants. An association between the motor repertoire and gestational age and birth weight was explored in extremely preterm infants without severe ultrasound abnormalities.

Methods: In a multicentre study, the early motor repertoire of 82 infants born extremely preterm (ELGAN:<28 weeks) and/or with extremely low birth weight (ELBW:<1000 g) and 87 term-born infants were assessed by the "Assessment of Motor Repertoire - 2 to 5 Months" (AMR) which is part of Prechtl's "General Movement Assessment", at 12 weeks post-term age. Fidgety movements were classified as normal if present and abnormal if absent, sporadic or exaggerated. Concurrent motor repertoire was classified as normal if smooth and fluent and abnormal if monotonous, stiff, jerky and/or predominantly fast or slow.

Results: Eight-teen ELBW/ELGAN infants had abnormal fidgety movements (8 absent, 7 sporadic and 3 exaggerated fidgety movements) compared with 2 control infants (OR:12.0; 95%CI:2.7-53.4) and 46 ELBW/ELGAN infants had abnormal concurrent motor repertoire compared with 17 control infants (OR:5.3; 95%CI:2.6-10.5). Almost all detailed aspects of the AMR differed between the groups. Results were the same when three infants with severe ultrasound abnormalities were excluded. In the remaining ELBW/ELGAN infants, there was no association between motor repertoire and gestational age or birth weight.

Conclusion: ELBW/ELGAN infants had poorer quality of early motor repertoire than term-born infants.The findings were not explained by severe abnormalities on neonatal ultrasound scans and were not correlated to the degree of prematurity. The consequences of these abnormal movement patterns remain to be seen in future follow-up studies.

Keywords: Abnormal motor repertoire; Extremely preterm infants; General movements; Term-born infants.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Birth Weight
Dyskinesias / epidemiology*
Female
Follow-Up Studies
Gestational Age
Humans
Infant
Infant, Extremely Premature*
Infant, Newborn
Infant, Premature, Diseases / epidemiology*
Male
Prevalence