Predictive value of definitely abnormal general movements in the general population.
OBJECTIVE
Definitely abnormal general movements in populations of high-risk infants predict serious neurodevelopmental impairment. This study aimed to assess predictive values of definitely abnormal general movements at 3 months for serious neurodevelopmental impairment in a representative sample of the general population.


METHODS
A prospective cohort study of 455 3-month-old infants was performed (241 females, 214 males; mean birthweight 3452g, SD 604g; mean gestational age 39.4wks, SD 1.96; n=32 born preterm). At enrolment, general movement quality was assessed by means of video recording. At 4 years, all participants were reassessed by well-baby health clinicians; if serious neurodevelopmental impairment was identified, clinical records were reviewed. Predictive values of definitely abnormal general movement quality for major neurodevelopmental impairment were calculated.


RESULTS
Five children were diagnosed as having a major neurodevelopmental disorder with serious implications for daily life, including three children with cerebral palsy (CP). Three out of the five had shown definitely abnormal general movements; they had lesions involving the periventricular white matter. Two children did not show definitely abnormal general movements; one had unilateral spastic CP due to a cortical lesion and the other had ataxia due to cerebellar atrophy. The positive predictive value of definitely abnormal general movements for major neurodevelopmental impairment was 18/100, and for CP it was 12/100. Negative predictive values approached 100%.


CONCLUSIONS
The good predictive value of general movement assessment in high-risk populations cannot be generalized to the general population.
Bouwstra
Hylco
H
Beatrix Children's Hospital - Developmental Neurology, University Medical Centre Groningen, 9713 GZ Groningen, the Netherlands.
Dijk-Stigter
Geerteke R
GR
Grooten
Hedwig M J
HM
Janssen-Plas
Femke Em
FE
Koopmans
Alice J
AJ
Mulder
Christien D
CD
van Belle
Ans
A
Hadders-Algra
Mijna
M
D002547:Cerebral Palsy / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D020820:Dyskinesias / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009460:Neurologic Examination / Q000706:statistics & numerical data; D044382:Population Groups / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity