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Boskabadi H, Sadr SH, Darabi A. Evaluating the relationship between aEEG findings and two-year prognosis in neonates with severe hyperbilirubinemia. Early Hum Dev 2024; 193:106031. [PMID: 38729065 DOI: 10.1016/j.earlhumdev.2024.106031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 04/27/2024] [Accepted: 04/29/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE Identifying factors that can better predict the prognosis of neonates with hyperbilirubinemia is important. In this study, we aimed to evaluate the relationship between electroencephalography (EEG) findings and two-year prognosis in neonates with severe hyperbilirubinemia. METHODS & MATERIALS In a cohort prospective study, we studied neonates with a total serum bilirubin level of higher than 18 mg/dL, who were admitted to the neonatal intensive care unit (NICU) of Ghaem hospital, Mashhad, Iran. EEG was recorded upon admission, for all neonates. Patients' data, including demographic characteristics, admission information, and pregnancy and birth data were gathered by obtaining history from parents and studying case files. Also, the relationship between initial EEG findings and final developmental status was assessed. RESULTS Mean and standard deviation age of patients were 5.46 ± 3.13 days and average serum total bilirubin level was 23.97 ± 4.34 mg/dL at admission. Our findings revealed a significant correlation between the presence of trace alternant on EEG and developmental delay (P = .001). Presence of trace alternant waves on initial EEG at admission was significantly associated with developmental delay in the two year (P = .005). CONCLUSION These results indicate a relationship between developmental prognosis and the severity of hyper bilirubinemia in neonates. Also, our findings show that the presence of trace alternate waves on the initial EEG is significantly associated with developmental delay of the neonate in the future.
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Affiliation(s)
- Hassan Boskabadi
- Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Susan Hashemi Sadr
- Department of Pediatrics, Student of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Azadeh Darabi
- Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Vallamkonda N, Bandyopadhyay T, Maria A. A Study of General Movement Assessment and Its Association With Neurodevelopmental Outcome at Age 12 to 15 Months Among Term Neonates With Hyperbilirubinemia. Pediatr Neurol 2024; 153:77-83. [PMID: 38341950 DOI: 10.1016/j.pediatrneurol.2023.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 09/12/2023] [Accepted: 12/31/2023] [Indexed: 02/13/2024]
Abstract
BACKGROUND To determine the association between optimality score at term age and age three to five months and neurodevelopmental outcome among neonates with hyperbilirubinemia. METHODS Fifty infants with and without hyperbilirubinemia were enrolled. The motor repertoires of the infants were evaluated through general movement assessment (GMA) at term age and three to five months post-term. The association between the General Movement Optimality Score (GMOS), Motor Optimality Score (MOS), and Development Assessment Scale for Indian Infants (DASII) at age 12 to 15 months was also assessed. RESULTS During term age, the median GMOS was significantly lower among infants in the study group when compared with the control group (40 [29 to 42] vs 42 [42 to 42], P < 0.001). However, at age three to five months, there was no significant difference between the groups. Significantly higher number of neonates had abnormal motor repertoire at term age and age three to five months in the study group when compared with the control group (18 [36%] vs 2 [4%], P = 0.001, at term age and 6 [12.2%] vs 1 [2%], P =0.04, at age three to five months). Among neonates with hyperbilirubinemia, the median GMOS and MOS were significantly lower at term age and age three to five months in infants with motor and mental developmental quotient scores <85 when compared with ≥85. CONCLUSIONS GMA including GMOS and MOS performed in neonates with hyperbilirubinemia during the neonatal period and early infancy is associated with neurodevelopmental outcomes in the first year of life. GMA can help initiate early intervention in such neonates.
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Affiliation(s)
- Nagaratna Vallamkonda
- Early Interventionist, Department of Neonatology, ABVIMS & Dr. RML Hospital, New Delhi, New Delhi, India
| | - Tapas Bandyopadhyay
- Associate Professor, Department of Neonatology, ABVIMS & Dr. RML Hospital, New Delhi, New Delhi, India
| | - Arti Maria
- Professor, Department of Neonatology, ABVIMS & Dr. RML Hospital, New Delhi, New Delhi, India.
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Merino-Andrés J, Pérez-Nombela S, Álvarez-Bueno C, Hidalgo-Robles Á, Ruiz-Becerro I, Fernández-Rego FJ. Neonatal hyperbilirubinemia and repercussions on neurodevelopment: A systematic review. Child Care Health Dev 2024; 50:e13183. [PMID: 37842871 DOI: 10.1111/cch.13183] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 07/11/2023] [Accepted: 09/25/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Accumulation of bilirubin above normal levels is considered a neurological risk factor for both premature and full-term newborns. This systematic review aimed to determine the effect of neonatal hyperbilirubinemia on neurodevelopment in preterm and full-term newborns. METHODS PubMed, EMBASE, Cochrane Library, CINAHL, PsycINFO, Scopus and Lilacs databases were searched for articles published until 1 June 2022. The quality of cohort and case-control studies was assessed with the Newcastle-Ottawa Scale, and the MINCir scale was used to evaluate the methodological quality of therapy studies or the therapeutic procedures. Premature neonates without neurological conditions and those born at term with hyperbilirubinemia as the sole risk factor were included. Studies reporting one or more neurodevelopmental outcomes were included with an inter-group comparison of a hyperbilirubinemia group versus a non-hyperbilirubinemia or non-pathological hyperbilirubinemia group. The main outcomes were auditory function, visual function, cognitive function, motor function, behavior, global development and neurological risk. RESULTS The search identified 951 studies, 19 of which (n = 2210 newborns) were finally included. Fifteen of the cohort and case-control studies presented low risk of bias, and six studies showed high methodological quality. Within the preterm population, hyperbilirubinemia as the sole risk factor was not shown to affect neurodevelopment. Auditory, neurological and motor development alterations were found in the population of full-term newborns with hyperbilirubinemia, which were more evident during the first year of life. CONCLUSIONS Elevated bilirubin levels may be a trigger for the onset of neurodevelopmental disorders in full-term infants during the first year of life. More studies are warranted in the preterm population with hyperbilirubinemia to draw conclusions about its impact on their neurodevelopment.
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Affiliation(s)
- Javier Merino-Andrés
- Faculty of Physiotherapy and Nursing, Physiotherapy Research Group of Toledo (GITFO), Universidad de Castilla-La Mancha, Toledo, Spain
- Physiotherapy Research Group of Toledo (GIFTO), Universidad de Castilla-La Mancha, Toledo, Spain
- Centro Crecer, Toledo, Spain
| | - Soraya Pérez-Nombela
- Faculty of Physiotherapy and Nursing, Physiotherapy Research Group of Toledo (GITFO), Universidad de Castilla-La Mancha, Toledo, Spain
- Physiotherapy Research Group of Toledo (GIFTO), Universidad de Castilla-La Mancha, Toledo, Spain
| | - Celia Álvarez-Bueno
- Social and Health Care Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Álvaro Hidalgo-Robles
- Physiotherapy Research Group of Toledo (GIFTO), Universidad de Castilla-La Mancha, Toledo, Spain
- Universidad Internacional de La Rioja, La Rioja, Spain
| | | | - Francisco Javier Fernández-Rego
- Physiotherapy Department, University of Murcia, Murcia, Spain
- Early Care Research Group (GIAT), University of Murcia, Murcia, Spain
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Merino-Andrés J, Pérez-Nombela S, Hidalgo-Robles Á, Pérez-Domínguez MDP, Prieto-Sánchez L, Fernández-Rego FJ. The Relationship between General Movements and Risk Factors in Moderate-Late Preterm Infants: A Prospective Cohort Study. J Clin Med 2023; 12:7763. [PMID: 38137832 PMCID: PMC10743437 DOI: 10.3390/jcm12247763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/14/2023] [Accepted: 12/16/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION Moderate-late preterm infants constitute the largest segment of preterm births globally. While previously considered to have a low neurological risk, recent research has uncovered an elevated incidence of neurodevelopmental conditions in this group. This study aimed to assess the relationship between the general movement assessment and birth-related risk factor-based tools in moderate-late preterm infants. METHODS A prospective cohort study of 65 moderate-late preterm infants in a neonatal intensive care unit involved the evaluation of general movements, the Nursery Neurobiologic Risk Score, and the Perinatal Risk Inventory. Associations were analyzed using Fisher's exact test, Spearman's correlation was used for ordinal variables, and backward stepwise logistic regression was used to identify predictor variables for the assessments. RESULTS The findings indicated a high prevalence of normal (41%) and poor (52%) repertoire patterns during the writhing period. While no significant associations were found between the three assessments, a slight approximation emerged between dysmorphic traits and patterns (p = 0.053). Furthermore, an extended period of ventilation correlated with a higher likelihood of developing a cramped synchronized pattern and there was a correlation between both risk factor-based tools (p < 0.001). CONCLUSIONS This research enhances our understanding of the early impact on general movement assessments in moderate-late preterm infants. While no clear relationship emerged between general movement assessment and risk factor-based tools, there was a subtle connection noted with dysmorphic traits. A longer ventilation duration was linked to a higher risk of developing cramped synchronized patterns.
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Affiliation(s)
- Javier Merino-Andrés
- Faculty of Physiotherapy and Nursing, Universidad de Castilla-La Mancha, Avenida de Carlos III s/n, 45071 Toledo, Spain;
- Physiotherapy Research Group of Toledo (GIFTO), Universidad de Castilla-La Mancha, Avenida de Carlos III s/n, 45071 Toledo, Spain
- Centro Crecer, 45007 Toledo, Spain
| | - Soraya Pérez-Nombela
- Faculty of Physiotherapy and Nursing, Universidad de Castilla-La Mancha, Avenida de Carlos III s/n, 45071 Toledo, Spain;
- Physiotherapy Research Group of Toledo (GIFTO), Universidad de Castilla-La Mancha, Avenida de Carlos III s/n, 45071 Toledo, Spain
| | | | | | - Lorena Prieto-Sánchez
- Hospital General Universitario Nuestra Señora del Prado, 45600 Talavera de la Reina, Spain; (M.d.P.P.-D.); (L.P.-S.)
| | - Francisco Javier Fernández-Rego
- Physiotherapy Department, University of Murcia, 30100 Murcia, Spain;
- Early Care Research Group (GIAT), University of Murcia, 30100 Murcia, Spain
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Akkaya KU, Eraslan R, Hanedan N, Onal EE, Koc E, Elbasan B. An investigation of motor development and sensory processing skills in infants with a history of hyperbilirubinemia. Early Hum Dev 2023; 184:105838. [PMID: 37544049 DOI: 10.1016/j.earlhumdev.2023.105838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/01/2023] [Accepted: 08/01/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Hyperbilirubinemia is a clinical picture frequently occurring in the neonatal period and may negatively affect the development of infants. AIMS To evaluate term infants with hyperbilirubinemia in terms of both motor development and sensory processing skills and to compare them with their healthy peers without hyperbilirubinemia. STUDY DESIGN A cross-sectional study. SUBJECTS Children born at term, aged 10-18 months, with and without a history of hyperbilirubinemia were included in the study. OUTCOME MEASURES After demographic information was recorded, motor development was evaluated with the Peabody Motor Development Scale-2 and sensory processing skills were evaluated with the Test of Sensory Function in Infant. RESULTS A total of 42 children (mean ± SD age of the children 13.07 ± 1.47 months, 22 with hyperbilirubinemia and 20 without hyperbilirubinemia) were included in the study. A statistically significant difference was found in the gross motor (p = 0.02), fine motor (p = 0.03), and total motor (p = 0.017) development scores of the Peabody Motor Development Scale-2 and in the adaptive motor functions (p = 0.004), visual tactile integration (p < 0.001), and total scores (p = 0.004) of The Test of Sensory Function in Infant in favor of the control group. CONCLUSIONS The motor and sensory processing skills of children born at term with hyperbilirubinemia may be negatively affected. Infants with hyperbilirubinemia should be evaluated from the early period not only in terms of motor but also sensory processing skills and should be supported with appropriate intervention programs.
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Affiliation(s)
- Kamile Uzun Akkaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey.
| | - Rabia Eraslan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Nurcan Hanedan
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Eray Esra Onal
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Esin Koc
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Bulent Elbasan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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Peyton C, Millman R, Rodriguez S, Boswell L, Naber M, Spittle A, de Regnier R, Barbosa VM, Sukal-Moulton T. Motor Optimality Scores are significantly lower in a population of high-risk infants than in infants born moderate-late preterm. Early Hum Dev 2022; 174:105684. [PMID: 36209602 PMCID: PMC10243476 DOI: 10.1016/j.earlhumdev.2022.105684] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND The Motor Optimality Score-Revised (MOS-R) is a detailed scoring of the General Movement Assessment (GMA), measuring the spontaneous behaviors of infants. Infants born moderate-late preterm are not traditionally followed in high-risk clinics, but have increased risk of neurodevelopmental disability. AIMS Compare MOS-R at 3 months corrected age (CA) in high-risk (HR; very preterm or abnormal neuroimaging) infants to infants born moderate-late preterm (MLP). STUDY DESIGN In this prospective cohort study, parents of enrolled infants created video recordings using an app at 3 months CA. Videos were scored with the General Movement Assessment (GMA) and MOS-R. MOS-R scores were divided into "higher-risk" (≤19) and "lower-risk" (≥20). SUBJECTS 181 infants born MLP or categorized as HR. RESULTS Among enrolled infants, 68 (38 %) were in the MLP group, and 113 infants were in the HR group. The HR group had 3.8 increased odds of having an aberrant GMA score compared to the MLP group (p < 0.01, 95 % CI 1.38-10.52). The HR group had significantly lower MOS-R scores (mean 20) than the MLP group (mean 24; p < 0.001; 95%CI 3.3-7.3). The HR group had 11.2 increased odds of having a higher-risk MOS-R score (95%CI 2.5-47.6, p < 0.001) than MLP group. Infants were most likely to have a lower MOS-R score if they had any of the following: VP shunt placement, periventricular leukomalacia, or bronchopulmonary dysplasia. CONCLUSIONS Aberrant GMA and higher-risk MOS-R scores were more common in infants at high-risk, reflecting history of brain lesions and younger gestational age at birth.
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Affiliation(s)
- Colleen Peyton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL 60611, USA; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL 60611, USA.
| | - Ryan Millman
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL 60611, USA
| | - Sarah Rodriguez
- Department of Ophthalmology and Visual Science, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA
| | - Lynn Boswell
- Ann and Robert H Lurie Children's Hospital, 225 E Chicago Ave, Chicago, IL 60611, USA
| | - Meg Naber
- Loyola University Medical Center, 2160 S. 1st Ave, Maywood, IL 60153, USA
| | - Alicia Spittle
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, VIC 3052, Australia
| | - RayeAnn de Regnier
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL 60611, USA; Ann and Robert H Lurie Children's Hospital, 225 E Chicago Ave, Chicago, IL 60611, USA
| | | | - Theresa Sukal-Moulton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL 60611, USA; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL 60611, USA
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Kwong AKL, Doyle LW, Olsen JE, Eeles AL, Zannino D, Mainzer RM, Cheong JLY, Spittle AJ. 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. Paediatr Perinat Epidemiol 2022; 36:673-682. [PMID: 35172019 DOI: 10.1111/ppe.12867] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/11/2022] [Accepted: 01/16/2022] [Indexed: 11/30/2022]
Abstract
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. A higher MOS-R is related to better outcomes for 2-year development, with similar relationships in both birth groups. Absent/abnormal fidgety movements are related to CP in EP/ELBW survivors.
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Affiliation(s)
- Amanda K L Kwong
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia.,Department of Physiotherapy, University of Melbourne, Parkville, Victoria, Australia
| | - Lex W Doyle
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
| | - Joy E Olsen
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia
| | - Abbey L Eeles
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia.,Department of Physiotherapy, University of Melbourne, Parkville, Victoria, Australia.,Department of Paediatrics, Monash University, Parkville, Victoria, Australia
| | - Diana Zannino
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Rheanna M Mainzer
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Jeanie L Y Cheong
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
| | - Alicia J Spittle
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia.,Department of Physiotherapy, University of Melbourne, Parkville, Victoria, Australia
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Kwong AKL, Boyd RN, Chatfield MD, Ware RS, Colditz PB, George JM. Early Motor Repertoire of Very Preterm Infants and Relationships with 2-Year Neurodevelopment. J Clin Med 2022; 11:1833. [PMID: 35407440 PMCID: PMC9000187 DOI: 10.3390/jcm11071833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/18/2022] [Accepted: 03/23/2022] [Indexed: 02/04/2023] Open
Abstract
The Motor Optimality Score, revised (MOS-R) is an extension of the Prechtl General Movements Assessment. This study aims to determine the relationship between MOS-R and 2-year neurodevelopmental outcomes in a cohort of 169 infants born very preterm (<31 weeks’ gestational age), and to examine the predictive validity of the MOS-R at 3−4 months’ corrected age (CA) above perinatal variables associated with poor outcomes, including Prechtl fidgety movements. Development at 2 years’ CA was assessed using Bayley Scales of Infant and Toddler Development, Third edition (Bayley-III) (motor/cognitive impairment: Bayley-III ≤ 85) and Neurological, Sensory, Motor, Developmental Assessment (NSMDA) (neurosensory motor impairment: NSMDA ≥ 12). Cerebral palsy (CP) was classified at 2 years as definite or clinical. The MOS-R was related to 2-year outcomes: Bayley-III motor (BMOS-R = 1.24 95% confidence interval (0.78, 1.70)), cognitive (BMOS-R = 0.91 (0.48, 1.35)), NSMDA scores (BMOS-R = −0.34 (−0.42, −0.25)), definite CP (odds ratio [OR] 0.67 (0.53, 0.86)), clinical CP (OR 0.74 (0.66, 0.83)) for each 1-point increase in MOS-R. MOS-R ≤ 23 predicted motor (sensitivity 78% (60−91%); specificity 63% (54−72%)) and neurosensory motor impairment (sensitivity 86% (64−97%); specificity 59% (51−68%)). The MOS-R is strongly related to CP and motor and cognitive delay at 2 years and is a good predictor of motor and neurosensory motor impairment.
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Affiliation(s)
- Amanda K.-L. Kwong
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4101, Australia; (A.K.-L.K.); (R.N.B.); (M.D.C.)
- Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia
- Department of Physiotherapy, University of Melbourne, Parkville, VIC 3010, Australia
| | - Roslyn N. Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4101, Australia; (A.K.-L.K.); (R.N.B.); (M.D.C.)
- Australian Cerebral Palsy Clinical Trials Network CRE, The University of Queensland, Brisbane, QLD 4101, Australia
| | - Mark D. Chatfield
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4101, Australia; (A.K.-L.K.); (R.N.B.); (M.D.C.)
- Australian Cerebral Palsy Clinical Trials Network CRE, The University of Queensland, Brisbane, QLD 4101, Australia
| | - Robert S. Ware
- Menzies Health Institutes Queensland, Griffith University, Brisbane, QLD 4222, Australia;
| | - Paul B. Colditz
- University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, QLD 4072, Australia;
- Perinatal Research Centre, Royal Brisbane and Women’s Hospital, Brisbane, QLD 4029, Australia
| | - Joanne M. George
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4101, Australia; (A.K.-L.K.); (R.N.B.); (M.D.C.)
- Australian Cerebral Palsy Clinical Trials Network CRE, The University of Queensland, Brisbane, QLD 4101, Australia
- Physiotherapy Department, Queensland Children’s Hospital, Children’s Health Queensland Hospital and Health Service, Brisbane, QLD 4101, Australia
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