Assessment of early motor repertoire in extremely preterm infants

The qualitative and quantitative aspects of an infant’s early motor behaviour may predict later neurological impairments. Assessment of early motor repertoire in the writhing and fidgety age is the evaluation method of early neuromotor development in order to determine neurodevelopmental risk. The aim of this study was to examine and describe the optimality of early motor repertoire and the quality of general movements in extremely preterm infants without evident brain injury. The study included 45 infants born before 28 gestational weeks with no evident brain lesion on magnetic resonance imaging at the term-equivalent age. The Prechtl assessment of general movements and the optimality of the motor repertoire was made at the term-equivalent age and at the corrected age of 3 months. Median gestational age was 25 weeks and 5 days. Normal writhing movements were observed in 13 (29%) infants. The median optimality score of motor repertoire at writhing age was 32 (interquartile range, IQR=20-40). Fidgety movements were observed in 34 (76%) infants. The median optimality score of the motor repertoire at the fidgety age was 22 (IQR=12-28). A poor repertoire of writhing movements is a common feature of early neuromotor development of extremely preterm infants, which is mostly transient in nature. The motor optimality score at fidgety age is lower than the one achieved by healthy termborn infants. The consequent absence of individual optimality criteria in motor behaviour of extremely preterm infants may serve as a starting point for planning targeted early interventions.

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