Movement assessment of infants as a predictor of one year neuromotor outcome in very low birth weight infants.

Objective: To predict neuromotor outcome in Very Low Birth Weight infants at 1 year using Movement Assessment of Infants scale at 4 and 8 months of corrected age.

Methods: This hospital based prospective observational study consecutively recruited 45 infants with birth weight ≤ 1,500 g and admitted to neonatal intensive care unit. The infants were evaluated at 4 and 8 months of corrected age using Movement Assessment of Infants scale and then a follow up evaluation was done at 1 year of corrected age with a neuropschycological tool, Bayley Scale of Infant Development-II and psychomotor development index was calculated to identify the neuromotor outcome.

Results: For predicting neuromotor outcome on the Bayleys motor scale at 1 year, the sensitivity of Movement Assessment of Infants for 4-month was 70%, specificity 83.3%, positive predictive value 58.3% and negative predictive value was 89.3% for risk points ≥ 10. The sensitivity of Movement Assessment of Infants for 8-month was 80%, specificity 93.3%, positive predictive value 80% and negative predictive value was 93.3% for risk points ≥ 10 .The correlations of the Movement Assessment of Infants total risk scores and categorical risk scores for muscle tone, primitive reflex, automatic reactions and volitional movement at 4 and 8 months with Bayley motor scale at 1 year were highly significant (p < 0.0000).

Conclusions: Movement Assessment of Infants is an effective clinical tool to identify neuromotor abnormalities, as the best predictive values for neuromotor outcome at 1 year in Very Low Birth Weight infants were obtained at 8-months and the 4-month Movement Assessment of Infants had high specificity and acceptable sensitivity.