Trajectories of detailed general movements and their association with one-year developmental outcomes in very preterm, moderate-to-late preterm, and term infants

Trajectories of early spontaneous movements provide valuable insights into developmental outcomes in preterm infants. We aimed to compare the longitudinal trajectory of early spontaneous movements in very preterm (VPT), moderate-to-late preterm (MLP) and term infants, and determine the relationship between early spontaneous movements and one-year developmental outcomes in preterm infants. This prospective longitudinal study included 133 infants, comprising 91 preterm and 42 term infants. Early spontaneous movements were assessed longitudinally according to the infants' ages, using the revised General Movements Assessment (GMA) score sheet, the General Movements Optimality Score-Revised (GMOS-R), and the Motor Optimality Score for 3-to 5-Month-Old Infants-Revised (MOS-R). Developmental outcomes were assessed using the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III). Two hundred and twenty-four video recordings for GMOS-R and 133 video recordings for MOS-R were evaluated. There was no difference in GMOS-R between VPT and MLP infants in the preterm or term periods (p = 0.343). However, VPT infants exhibited lower GMOS-R (p = 0.001) in the postterm period and lower MOS-R (p = 0.018) in the fidgety period compared to term infants. VPT infants had lower Bayley-III outcomes than MLP infants in the cognitive (p = 0.006), language (p = 0.003), and motor domains (p = 0.004), and lower motor outcome than term infants (p < 0.001). GMOS-R in the preterm or term periods was correlated only with motor outcomes (p = 0.002; r = 0.329), while in the postterm period GMOS-R was correlated with cognitive (p = 0.039; r = 0.222), language (p = 0.045; r = 0.215), and motor (p = 0.001; r = 0.340) outcomes in all preterm infants. MOS-R was also related with cognitive (p < 0.001; r = 0.396), language (p = 0.005; r = 0.301), and motor (p < 0.001; r = 0.457) outcomes. CONCLUSION: This study supports the concept that VPT infants are at high-risk of developmental problems. Additionally, while the relationship of GMOS-R to developmental outcomes is highlighted, MOS-R is more strongly associated with later developmental outcomes. WHAT IS KNOWN: • Time-based General Movements Assessment through trajectories provide important information to identify infants at high neurodevelopmental risk. WHAT IS NEW: • The General Movements Optimality Score-Revised (GMOS-R) may support early risk stratification in the earliest months of life and is potentially informative for early intervention referrals. However, MOS-R demonstrates stronger overall associations, highlighting its important role in early developmental assessments.