title: Fidgety movements in infants born very preterm: predictive value for cerebral palsy in a clinical multicentre setting.
abstract: OBJECTIVE
  This study assessed predictive values of fidgety movement assessment (FMA) in a large sample of infants born very preterm for developmental abnormalities, in particular for cerebral palsy (CP) at 2 years in an everyday clinical setting.
  
  
  METHODS
  This is a multicentre study of infants born preterm with gestational age lower than 32.0 weeks. FMA was performed at 3 months corrected age; neurodevelopment (Bayley Scales of Infant Development, 2nd edition) and neurological abnormalities were assessed at 2 years. Predictive values of FMA for the development of CP were calculated and combined with abnormalities at cerebral ultrasound.
  
  
  RESULTS
  Five hundred and thirty-five infants (gestational age 28.2wks [standard deviation 1.3wks]) were included. Eighty-one percent showed normal fidgety movements and 19% atypical (82 absent, 21 abnormal) fidgety movements. Absent fidgety movements predicted CP at 2 years with an odds ratio (OR) of 8.9 (95% confidence interval [CI] 4.1-17.0), a combination of atypical fidgety movements and major brain lesion on cerebral ultrasound predicted it with an OR of 17.8 (95% CI 5.2-61.6). Mean mental developmental index of infants with absent fidgety movements was significantly lower (p=0.012) than with normal fidgety movements.
  
  
  CONCLUSIONS
  Detection of infants at risk for later CP through FMA was good, but less robust when performed in a routine clinical setting; prediction improved when combined with neonatal cerebral ultrasound.
authors.affiliation: Division of Neuropediatrics and Developmental Medicine, University of Basel Children's Hospital, Basel, Switzerland.|Department of Development and Growth, University Children's Hospital Geneva, Geneva, Switzerland.
authors.forename: Alexandre N
authors.initials: AN
authors.lastname: Datta
authors.affiliation: Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital Bern, Inselspital, Bern University Hospital, Bern, Switzerland.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Furrer
authors.affiliation: Institute for Physical Therapy, Inselspital, Bern University Hospital, Bern, Switzerland.
authors.forename: Iris
authors.initials: I
authors.lastname: Bernhardt
authors.affiliation: Department of Development and Growth, University Children's Hospital Geneva, Geneva, Switzerland.
authors.forename: Petra S
authors.initials: PS
authors.lastname: Hüppi
authors.affiliation: Department of Development and Growth, University Children's Hospital Geneva, Geneva, Switzerland.
authors.forename: Cristina
authors.initials: C
authors.lastname: Borradori-Tolsa
authors.affiliation: Division of Neonatalology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Hans Ulrich
authors.initials: HU
authors.lastname: Bucher
authors.affiliation: Child Development Centre, University Children's Hospital Zurich, Zurich, Switzerland.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Latal
authors.affiliation: Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital Bern, Inselspital, Bern University Hospital, Bern, Switzerland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Grunt
authors.affiliation: Division of Neonatalology, University Hospital Zurich, Zurich, Switzerland.|Child Development Centre, University Children's Hospital Zurich, Zurich, Switzerland.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Natalucci
mesh_terms: D002547:Cerebral Palsy / Q000175:diagnosis* / Q000503:physiopathology; D002657:Child Development; D002675:Child, Preschool; D004453:Echoencephalography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007234:Infant, Premature; D008297:Male; D009068:Movement; D011379:Prognosis; D013557:Switzerland