Papers

Objective: Fidgety movements have high predictive validity for later cerebral palsy (CP) but their temporal organisation requires further understanding for assessment accuracy.This paper aims to describe the occurrence of and temporal trends in fidgety movements, and whether they differ between infants born preterm and at term.Design: Cohort study.Method: Up to two videos were received at 12-13 +6 and/or 14-16 +6 weeks' corrected age of infants born extremely preterm (EP) (<28 weeks' gestation) and/or extremely low birthweight (ELBW) (<1000g birthweight) or at term (37-42 weeks' gestation).Videos were scored using the Prechtl General Movements Assessment (GMA) (fidgety) and classified as normal or absent/abnormal.Infants with at least one normal GMA were classified as normal.Individual GMA trajectories were analysed over time using mixed-effects logistic regression.Results: We received at least one video from parents of 155 infants born EP/ELBW and 185 infants born at term.Overall, infants born EP/ELBW were more likely to have absent/abnormal fidgety movements than infants born at term (23% vs 3%, odds ratio [OR] 8.50 (95% confidence interval (CI) 3. 48-20.8,p<0.001).Fewer infants born EP/ELBW and at term showed absent/abnormal fidgety movements with each week of increasing age (EP/ELBW OR 0.46, 95% CI 0.25-0.84,p=0.01; term-born OR 0.35, 95% CI 0.16-0.8,p=0.01; interaction, p=0.53).Conclusion: Absent/abnormal fidgety movements are more prevalent in infants born EP/ELBW than at term.Fidgety movements normalise with older age both infant groups between 12-16 +6 weeks' corrected age.If only one GMA is possible, a later assessment between 12-16 +6 weeks' corrected age is preferred.