title: Predictive value of general movements' quality in low-risk infants for minor neurological dysfunction and behavioural problems at preschool age.
abstract: BACKGROUND
  General movement (GM) assessment is a well-established tool to predict cerebral palsy in high-risk infants. Little is known on the predictive value of GM assessment in low-risk populations.
  
  
  OBJECTIVE
  To assess the predictive value of GM quality in early infancy for the development of the clinically relevant form of minor neurological dysfunction (complex MND) and behavioral problems at preschool age.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  A total of 216 members of the prospective Groningen Assisted Reproductive Techniques (ART) cohort study were included in this study. ART did not affect neurodevelopmental outcome of these relatively low-risk infants born to subfertile parents.
  
  
  METHODS
  GM quality was determined at 2 weeks and 3 months. At 18 months and 4 years, the Hempel neurological examination was used to assess MND. At 4 years, parents completed the Child Behavior Checklist; this resulted in the total problem score (TPS), internalizing problem score (IPS), and externalizing problem score (EPS). Predictive values of definitely (DA) and mildly (MA) abnormal GMs were calculated.
  
  
  RESULTS
  DA GMs at 2 weeks were associated with complex MND at 18 months and atypical TPS and IPS at 4 years (all p<0.05). Sensitivity and positive predictive value of DA GMs at 2 weeks were rather low (13%-60%); specificity and negative predictive value were excellent (92%-99%). DA GMs at 3 months occurred too infrequently to calculate prediction. MA GMs were not associated with outcome.
  
  
  CONCLUSIONS
  GM quality as a single predictor for complex MND and behavioral problems at preschool age has limited clinical value in children at low risk for developmental disorders.
authors.affiliation: Division Developmental Neurology,Department of Paediatrics,University Medical Center Groningen,University of Groningen, Hanzeplein 1, Groningen GZ 9713, The Netherlands.
authors.forename: Anne N
authors.initials: AN
authors.lastname: Bennema
authors.affiliation: Division Developmental Neurology,Department of Paediatrics,University Medical Center Groningen,University of Groningen, Hanzeplein 1, Groningen GZ 9713, The Netherlands.
authors.forename: Pamela
authors.initials: P
authors.lastname: Schendelaar
authors.affiliation: Division Developmental Neurology,Department of Paediatrics,University Medical Center Groningen,University of Groningen, Hanzeplein 1, Groningen GZ 9713, The Netherlands.
authors.forename: Jorien
authors.initials: J
authors.lastname: Seggers
authors.affiliation: Department of Genetics, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen GZ 9713, The Netherlands.
authors.forename: Maaike L
authors.initials: ML
authors.lastname: Haadsma
authors.affiliation: Department of Obstetrics and Gynaecology, Academic Medical Center, Meibergdreef 9, Amsterdam AZ 1105, The Netherlands.
authors.forename: Maas Jan
authors.initials: MJ
authors.lastname: Heineman
authors.affiliation: Division Developmental Neurology,Department of Paediatrics,University Medical Center Groningen,University of Groningen, Hanzeplein 1, Groningen GZ 9713, The Netherlands. Electronic address: m.hadders-algra@umcg.nl.
authors.forename: Mijna
authors.initials: M
authors.lastname: Hadders-Algra
mesh_terms: D000328:Adult; D001526:Behavioral Symptoms / Q000175:diagnosis*; D002657:Child Development; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009068:Movement; D009460:Neurologic Examination / Q000379:methods*; D011237:Predictive Value of Tests
keywords: Behavioral problems; General movements; Infants; Minor neurological dysfunction; Neurological examination; Predictive value