General movements in the perinatal period and its relation to echogenicity changes in the brain.
BACKGROUND
In preterm born infants abnormal general movements (GMs) generally normalize before three months post term, but may persist when perinatal brain injury is present.


OBJECTIVE
To assess the continuity of GM quality from fetal to early neonatal period and its relation to brain echogenicity changes.


METHODS
Prospective study examining GMs and three vulnerable brain areas before and 7days after birth. The quality of GMs was classified as normal or abnormal by Gestalt-perception. The brain was examined for moderate echogenicity changes (periventricular: brighter than choroid plexus, intraventricular: filling equal or more than 50% of the ventricle, and locally increased basal ganglia/thalami).


METHODS
94 fetuses from pregnancies complicated by preterm hypertensive disorders or labour at a gestational age between 26 and 34weeks.


METHODS
Correlations of fetal GMs, echogenicity changes, and clinical parameters (e.g. gestational age, parity, hypertensive disorders or preterm labour, oligohydramnios and fetal growth restriction) with neonatal GMs.


RESULTS
Fetal GMs were abnormal in 64%, normalizing in 68% within 7days after birth. Fetal GMs were significantly related to postnatal GMs (p=0.045). Moderate fetal brain echogenicity changes and clinical parameters were not significantly related to neonatal GM.


CONCLUSIONS
In this population of pregnancies compromised by hypertensive disorders or preterm labour fetal GMs correlated with neonatal GMs. Presence of moderate echogenicity changes in the fetal brain was not related to neonatal GMs.
Department of Obstetrics and Gynaecology, Research Institute MOVE, VU University Medical Center, Amsterdam, The Netherlands. fleur.rosier@inter.nl.net <fleur.rosier@inter.nl.net>
Fleur M
FM
Rosier-van Dunné
Gerda
G
van Wezel-Meijler
Maaike P
MP
Bakker
Laila
L
de Groot
Hein J
HJ
Odendaal
Johanna I
JI
de Vries
D000328:Adult; D001921:Brain / Q000196:embryology / Q000502:physiology*; D001931:Brain Mapping; D002552:Cerebral Ventricles / Q000502:physiology; D002831:Choroid Plexus / Q000502:physiology; D004453:Echoencephalography / Q000379:methods*; D005260:Female; D005324:Fetal Movement / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development / Q000502:physiology*; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology; D047928:Premature Birth / Q000503:physiopathology; D011446:Prospective Studies; D011596:Psychomotor Disorders / Q000503:physiopathology*; D013997:Time Factors; D014741:Video Recording