COMPARISON OF THE PREDICTIVE VALUES OF EARLY NEURODEVELOPMENTAL ASSESSMENTS AND EVALUATION OF GENERAL MOVEMENTS FOR MOTOR OUTCOME IN PRETERM INFANTS WITH BIRTH WEIGHTS <1500 G

Objectives: Comparison of predictive values of neurodevelopmental assessment and evaluation of videotaped spontaneous movements at age 3 months with regard to motor outcome at age 20 months.

Methods: Prospective longitudinal study of 103 VLBW infants, 96 (455–1490g, 24–35 weeks gestational age) including (a) neurodevelopmental assessment based on criteria by Amiel-Tison/Grenier at 40 weeks postconceptional age, 3 months, and 20 months corrected age; (b) evaluation of general movements with fidgety character, based on criteria by Prechtl, at 3 months; and (c) standardized testing of motor development using the Griffiths Developmental Scales at 20 months. We calculated sensitivity, specificity and predictive values for each method.

Results: Predicting motor outcome, the assessment of general movements had a positive predictive value of 89% and negative predictive value of 84%. For neurodevelopmental assessment at 40 weeks postconceptional age, positive predictive value was 33% and negative predictive value 88% respectively, with similar results for neurodevelopmental assessment at age 3 months.

Conclusion: Normal motor outcome of VLBW infants may be accurately predicted by clinical neurodevelopmental assessment, but for adverse outcomes, evaluation of general movements (fidgety movements) is superior. It is a simple, repeatable and non-intrusive technique, and may be a valuable method for early detection of central nervous system impairment in VLBW infants in routine follow-up.