Comparison between observation of spontaneous movements and neurologic examination in preterm infants*
Section snippets
Neurologic examination and follow-up until 2 years of age
During the preterm period and at term age, repeated neurologic examinations were performed according to the Dubowitz6 and Prechtl5 protocols, respectively. Development during the first 6 months after term was assessed on the same occasion as the recordings of spontaneous motility were made (see below), by means of the Amiel-Tison and Grenier examination22 or by use of the Touwen criteria.23 Later development was checked at 24 months of corrected age, when the infants were also tested by the
RESULTS
The main results obtained are reported in Tables II and III.
Empty Cell Preterm period Term age Postterm period Postmenstrual age (wk) 28-37 38-42 43-47 48-56 57-65 No. of cases 65 60 61 66 61 GM observation Normal (%) 30.8 33.3 37.7 42.4 49.2 Abnormal (%) 69.2 66.7 62.3 57.6 50.8 Neurologic examination results Normal (%) 36.9 48.3 32.8 36.4 47.6 Abnormal (%) 63.1 51.7 67.2 63.6 52.4 Agreement (%) 72.9 74.2 78.7 83.1 92.6
DISCUSSION
One of the aims of this study was to evaluate the concordance of neurologic findings and GM observations when executed at the same age in preterm infants. The limited diagnostic and prognostic value of neurologic examination during the preterm and term periods might explain why the overall agreement between the two techniques was found to be fair and strongly age related.
In the first weeks after birth, physical conditions (e.g., anemia, jaundice, apneas, cardiac instability) may account for
Acknowledgements
We thank Prof. C. Cipolloni and the staff of the neonatal intensive care unit of the University of Pisa where some of the cases were observed. We also thank P. Morse for assistance with the English version of the manuscript and P. Magni for the illustration.
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Supported in part by grants from the Italian Ministries of Health and of Scientific Research and Universities.