Total score and subscores of Prechtl’s Motor Optimality Score-Revised in infants born of mothers in Opioid Replacement Therapy during pregnancy

To investigate the motor repertoire at 3-4 month in infants born to mothers receiving ORT during pregnancy using Prechtl’s Motor Optimality Score-Revised (MOS-R).

In the prospective cohort study Children Exposed to Drugs and/or Alcohol in Intrauterine Life (CEADIL), infants attending a hospital follow up program in Norway are followed prospectively from 3 months of age. We compare infants born to mothers receiving ORT during pregnancy (ORT group, still including, n=12) with infants exposed to alcohol and/or drugs during pregnancy (CEADIL group, n=98) and a group of healthy unexposed children (control group, n=106). 

Video recordings at 3-4 months of age were analyzed certified physiotherapists blinded to infant history and group. Outcome variables were MOS-R score ≤24, Fidgety Movements, classified as present, sporadic, absent or exaggerated, and Movement Repertoire, classified as present, reduced or absent. 

Data were analyzed in SPSS using Mann-Whitney U test for three group comparisons and Pearson’s Chi Square for two group comparisons.

In  preliminary analyses 41.7% (n=5) children in the ORT group and 43.4% (n=43) children in the CEADIL group had a MOS-R score ≤24 (p=0.93) compared with 11.5% (n=12) children in the control group (p0.001). Movement Character was abnormal for 58.3% (n=7) children in the ORT group and 64% (n=63) children i the CEADIL group, (p=0.7), compared with 22.1% (n=23) children in the control group (p0.001). 

Although not statistically significant between the three groups, Fidgety Movements was abnormal (sporadic, exaggerated) for 16.7% (n=2) children in the ORT group, 11.1% (n=11) children in the CEADIL group and only 3.8% (n=4) children in the control group.

Children in the ORT group and the CEADIL group had reduced spontaneous movements, assessed with the MOS-R, compared to the control group.

There was no significant differences between the ORT and the CEADIL group.

Using MOS-R as a motor assessment in infants born to mothers receiving ORT and infants exposed to drugs, alcohol or medicines during pregnancy can help us identify infants at risk of adverse development, and provide targeted health care services from early life. The MOS-R can also be used to identify infants with typical motor development for reassuring their parents.