title: General movements in very preterm children and neurodevelopment at 2 and 4 years.
abstract: OBJECTIVE
  Although ~50% of very preterm (VP) children have neurodevelopmental impairments, early prediction of infants who will experience problems later in life remains a challenge. This study evaluated the predictive value of general movements (GM; spontaneous and endogenous movements) at 1 and 3 months' corrected age for neurodevelopment at 2 and 4 years of age in VP children.
  
  
  METHODS
  At 1 and 3 months' corrected age, infants born <30 weeks' gestation had GM assessed as normal or abnormal. Motor, cognitive, and language development at 2 years was assessed by using the Bayley Scales of Infant and Toddler Development, Third Edition. At 4 years, cognitive and language outcomes were assessed by using the Differential Ability Scale-Second Edition and motor outcomes with the Movement Assessment Battery for Children-Second Edition; a diagnosis of cerebral palsy was documented.
  
  
  RESULTS
  Ninety-nine VP infants were recruited, with 97% and 88% of survivors followed up at age 2 and 4 years, respectively. Abnormal GM at 1 month were associated with worse motor outcomes at 2 and 4 years but not language or cognitive outcomes. Abnormal GM at 3 months were associated with worse motor, cognitive, and language outcomes at both 2 and 4 years. Overall, GM at 1 month demonstrated better sensitivity to impairments at 2 and 4 years, whereas GM at 3 months had better specificity and were more accurate overall at distinguishing between children with and without impairment.
  
  
  CONCLUSIONS
  Abnormal GM in VP infants, particularly at 3 months postterm, are predictive of worse neurodevelopment at ages 2 and 4 years.
authors.affiliation: Victorian Infant Brain Study, Murdoch Childrens Research Institute, Melbourne, Australia. alicia.spittle@mcri.edu.au
authors.forename: Alicia J
authors.initials: AJ
authors.lastname: Spittle
authors.forename: Megan M
authors.initials: MM
authors.lastname: Spencer-Smith
authors.forename: Jeanie L Y
authors.initials: JL
authors.lastname: Cheong
authors.forename: Abbey L
authors.initials: AL
authors.lastname: Eeles
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Lee
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Anderson
authors.forename: Lex W
authors.initials: LW
authors.lastname: Doyle
mesh_terms: D002547:Cerebral Palsy / Q000175:diagnosis; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis; D002658:Developmental Disabilities / Q000175:diagnosis*; D042241:Early Diagnosis; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007805:Language Development Disorders / Q000175:diagnosis; D008137:Longitudinal Studies; D008297:Male; D009043:Motor Activity; D011237:Predictive Value of Tests; D011596:Psychomotor Disorders / Q000175:diagnosis; D014739:Victoria
keywords: general movements assessment; neurodevelopmental outcome; preterm infant