Fidgety movements in infants born very preterm: predictive value for cerebral palsy in a clinical multicentre setting

<jats:sec><jats:title>Aim</jats:title><jats:p>This study assessed predictive values of fidgety movement assessment (<jats:styled-content style="fixed-case">FMA</jats:styled-content>) in a large sample of infants born very preterm for developmental abnormalities, in particular for cerebral palsy (<jats:styled-content style="fixed-case">CP</jats:styled-content>) at 2 years in an everyday clinical setting.</jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p>This is a multicentre study of infants born preterm with gestational age lower than 32.0 weeks. <jats:styled-content style="fixed-case">FMA</jats:styled-content> 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 <jats:styled-content style="fixed-case">FMA</jats:styled-content> for the development of <jats:styled-content style="fixed-case">CP</jats:styled-content> were calculated and combined with abnormalities at cerebral ultrasound.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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 <jats:styled-content style="fixed-case">CP</jats:styled-content> at 2 years with an odds ratio (<jats:styled-content style="fixed-case">OR</jats:styled-content>) of 8.9 (95% confidence interval [<jats:styled-content style="fixed-case">CI</jats:styled-content>] 4.1–17.0), a combination of atypical fidgety movements and major brain lesion on cerebral ultrasound predicted it with an <jats:styled-content style="fixed-case">OR</jats:styled-content> of 17.8 (95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 5.2–61.6). Mean mental developmental index of infants with absent fidgety movements was significantly lower (<jats:italic>p</jats:italic>=0.012) than with normal fidgety movements.</jats:p></jats:sec><jats:sec><jats:title>Interpretation</jats:title><jats:p>Detection of infants at risk for later <jats:styled-content style="fixed-case">CP</jats:styled-content> through <jats:styled-content style="fixed-case">FMA</jats:styled-content> was good, but less robust when performed in a routine clinical setting; prediction improved when combined with neonatal cerebral ultrasound.</jats:p></jats:sec>