Huang K-Y1, Hsue B-J1
1National Cheng Kung University, Physical Therapy, Tainan, Taiwan
Background: Infants born preterm are in greater risks for developmental disabilities. Detecting disabilities in different varieties of severity and patterns in infancy allows early intervention. Qualitative assessment of general movements (GMsA) is a method used to assess brain integrity by identifying normal/abnormal spontaneous movements during infancy. Most of GMsA works focus on neuromotor outcome and less on cognitive outcome, although pathological change of brain is one of the causes lead to cognitive problems. Moreover, the developmental problems in this population may be not limited in motor function; the cognitive problem be not shown in early age, but it's influences can be life-long. This study aims to determine the correlation with GMsA trajectories and cognition.
Purpose: To investigate whether trajectory findings of GMsA in three periods, preterm, writhing and fidgety, in premature infants correlate with cognitive performances at the age of three.
Methods: Thirty-one premature infants (mean gestational age: 32.22±2.98 weeks; mean birth weight: 1732.13±584.34 g) who met the inclusion criteria were recruited from National Cheng Kung University Hospital. The spontaneous movements of each participant were recorded by two camcorders in three periods, preterm, writhing and fidgety, and dichotomized as normal or abnormal by a physical therapist who was blind to the participant's condition. An individual trajectory with abnormal end in fidgety period was defined as abnormal. Cognitive development at 3 years was assessed by using the Bayley Scales of Infant and Toddler Development, 3rd Edition. The correlations between abnormal trajectories and cognitive development were determined with Spearman rank correlation coefficient. Statistical significance level was 0.05.
Results: Six out of 31 infants' trajectories of GMsA were classified as abnormal. The mean age at follow up was 36.20±0.33 months, and the mean cognitive score was 114.84±16.6. There was one child with normal trajectories scored 2 standard deviations below the mean. In six children with abnormal trajectories, only two of them had scores less than the average score of norm; among the rest four children, one was diagnosed with cerebral palsy. Low correlation among GMsA trajectories and cognitive scores at three years of age (r=0.129, p=0.490).
Conclusion(s): Abnormal GMsA trajectories have shown its connections with later motor disabilities in previous studies. However, low correlation was found between trajectories and cognitive scores for premature infants in this study. Definitions of abnormal trajectories may vary the results; for example, some studies considered being abnormal in at least two periods as an abnormal trajectory. Optimal definition needs further discussion. Medical condition and prematurity of the infants may also affect the results. There are some limitations in present study, such as small sample size. Environmental factors that may have influences on the cognitive outcome, such as socioeconomic status of parents, should be analyzed in future studies.
Implications: Individual trajectories of GMsA provide more information of the developing brains of premature infants, but its application in the prediction of cognitive outcomes of premature infants needs further studies.
Keywords: Premature infants, general movements, cognition
Funding acknowledgements: Ministry of Science and Technology of Taiwan
Purpose: To investigate whether trajectory findings of GMsA in three periods, preterm, writhing and fidgety, in premature infants correlate with cognitive performances at the age of three.
Methods: Thirty-one premature infants (mean gestational age: 32.22±2.98 weeks; mean birth weight: 1732.13±584.34 g) who met the inclusion criteria were recruited from National Cheng Kung University Hospital. The spontaneous movements of each participant were recorded by two camcorders in three periods, preterm, writhing and fidgety, and dichotomized as normal or abnormal by a physical therapist who was blind to the participant's condition. An individual trajectory with abnormal end in fidgety period was defined as abnormal. Cognitive development at 3 years was assessed by using the Bayley Scales of Infant and Toddler Development, 3rd Edition. The correlations between abnormal trajectories and cognitive development were determined with Spearman rank correlation coefficient. Statistical significance level was 0.05.
Results: Six out of 31 infants' trajectories of GMsA were classified as abnormal. The mean age at follow up was 36.20±0.33 months, and the mean cognitive score was 114.84±16.6. There was one child with normal trajectories scored 2 standard deviations below the mean. In six children with abnormal trajectories, only two of them had scores less than the average score of norm; among the rest four children, one was diagnosed with cerebral palsy. Low correlation among GMsA trajectories and cognitive scores at three years of age (r=0.129, p=0.490).
Conclusion(s): Abnormal GMsA trajectories have shown its connections with later motor disabilities in previous studies. However, low correlation was found between trajectories and cognitive scores for premature infants in this study. Definitions of abnormal trajectories may vary the results; for example, some studies considered being abnormal in at least two periods as an abnormal trajectory. Optimal definition needs further discussion. Medical condition and prematurity of the infants may also affect the results. There are some limitations in present study, such as small sample size. Environmental factors that may have influences on the cognitive outcome, such as socioeconomic status of parents, should be analyzed in future studies.
Implications: Individual trajectories of GMsA provide more information of the developing brains of premature infants, but its application in the prediction of cognitive outcomes of premature infants needs further studies.
Keywords: Premature infants, general movements, cognition
Funding acknowledgements: Ministry of Science and Technology of Taiwan
Topic: Paediatrics; Outcome measurement
Ethics approval required: Yes
Institution: National Cheng Kung University Hospital
Ethics committee: Institutional Review Board for Human Experiment and Ethics
Ethics number: B-BR-101-173
All authors, affiliations and abstracts have been published as submitted.
