Occurrence of and temporal trends in fidgety general movements in infants born extremely preterm/extremely low birthweight and term-born controls.

BACKGROUND: Fidgety general movements have high predictive validity for later cerebral palsy (CP) but their temporal organisation requires further understanding for assessment accuracy.

AIMS: To describe the occurrence of and temporal trends in fidgety movements, and whether they differ between infants born preterm and at term.

STUDY DESIGN: Cohort study.

SUBJECTS: We assessed 155 EP/ELBW infants and 185 term-born infants born extremely preterm (EP; <28 weeks' gestation) and/or extremely low birthweight (ELBW; <1000 g birthweight) or at term (37-42 weeks' gestation) in the state of Victoria, Australia.

OUTCOME MEASURES: Parents of infants submitted up to two videos at 12-13+6 and/or 14-16+6 weeks' corrected age of infants' general movements. Videos were scored using the Prechtl General Movements Assessment (GMA) (fidgety) and classified as normal or absent/abnormal. Infants with at least one normal GMA were classified as normal. Individual GMA trajectories were analysed over time using logistic regression.

RESULTS: Overall, infants born EP/ELBW were more likely to have absent/abnormal fidgety movements than term-born infants (23% versus 3%, odds ratio [OR] 8.50 (95% confidence interval (CI) 3.48-20.8, p < 0.001). Fewer EP/ELBW and term-born infants showed absent/abnormal fidgety movements with each week of increasing age (EP/ELBW OR 0.46, 95% CI 0.25-0.84, p = 0.01; term-born OR 0.35, 95% CI 0.16-0.8, p = 0.01; interaction, p = 0.53).

CONCLUSIONS: Absent/abnormal fidgety movements are more prevalent in infants born EP/ELBW than at term. Fidgety movements normalise with older age in both infants born EP/ELBW and at term between 12 and 16+6 weeks' corrected age.