scholarly journals The general movements assessment in term and late-preterm newborns diagnosed with neonatal encephalopathy, as a predictive tool of cerebral palsy by two years of age: a scoping review protocol.

2020 ◽  
Author(s):  
Judy Seesahai ◽  
Maureen Luther ◽  
Carmen Cindy Rhoden ◽  
Paige Terrien Church ◽  
Elizabeth Asztalos ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Randomized Controlled Trials ◽  
Preterm Infants ◽  
Scoping Review ◽  
Late Preterm ◽  
Controlled Trials ◽  
Neonatal Encephalopathy ◽  
Late Preterm Infants ◽  
Randomized Controlled ◽  
General Movements

Abstract Background Prediction of long-term neurodevelopmental outcomes remains an elusive goal for neonatology. Clinical and socioeconomic markers have not proven to be adequately reliable. The limitation in prognostication includes those term and late-preterm infants born with neonatal encephalopathy. The General Movements Assessment tool by Prechtl has demonstrated reliability for identifying infants at risk for neuromotor impairment. This tool is non-invasive and cost-effective. The purpose of this study is to identify the published literature on how this tool applies to the prediction of cerebral palsy in term and late-preterm infants diagnosed with neonatal encephalopathy and so detect the research gaps. Methods We will conduct a systematic scoping review for data on sensitivity, specificity, positive and negative predictive value and describe the strengths and limitations of the results. This review will consider studies that included neonates more than or equal to 34+0 weeks gestational age, diagnosed with neonatal encephalopathy, with a General Movements Assessment done between birth to six months of life and an assessment for cerebral palsy by at least two years of age. Experimental and quasi-experimental study designs including randomized controlled trials, non-randomized controlled trials, before and after studies, interrupted time-series studies and systematic reviews will be considered. Text and opinion papers will not be considered for inclusion in this scoping review as this is a highly specific and medical topic. Studies in the English language only will be considered. Studies published from at least 1970 will be included as this is around the time when the General Movements Assessment was first introduced in neonatology as a potential predictor of neuromotor outcomes. We will search five databases (MEDLINE, Embase, PsychINFO, Scopus and CINAHL). Two reviewers will conduct all screening and data extraction independently. The articles will be categorized according key findings and a critical appraisal performed.Discussion The results of this review will guide future research to improve early identification and timely intervention in neonates with neonatal encephalopathy at risk of neuromotor impairment.Systematic review registration Title registration with Joanna Briggs Institute.

scholarly journals The general movements assessment in term and late-preterm infants diagnosed with neonatal encephalopathy, as a predictive tool of cerebral palsy by two years of age: a scoping review protocol.

2020 ◽  
Author(s):  
Judy Seesahai ◽  
Maureen Luther ◽  
Carmen Cindy Rhoden ◽  
Paige Terrien Church ◽  
Elizabeth Asztalos ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Randomized Controlled Trials ◽  
Preterm Infants ◽  
Scoping Review ◽  
Late Preterm ◽  
Controlled Trials ◽  
Neonatal Encephalopathy ◽  
Late Preterm Infants ◽  
Randomized Controlled ◽  
General Movements

Abstract Background Prediction of long-term neurodevelopmental outcomes remains an elusive goal for neonatology. Clinical and socioeconomic markers have not proven to be adequately reliable. The limitation in prognostication includes those term and late-preterm infants born with neonatal encephalopathy. The General Movements Assessment tool by Prechtl has demonstrated reliability for identifying infants at risk for neuromotor impairment. This tool is non-invasive and cost-effective. The purpose of this study is to identify the published literature on how this tool applies to the prediction of cerebral palsy in term and late-preterm infants diagnosed with neonatal encephalopathy and so detect the research gaps. Methods We will conduct a systematic scoping review for data on sensitivity, specificity, positive and negative predictive value and describe the strengths and limitations of the results. This review will consider studies that included infants more than or equal to 34+0 weeks gestational age, diagnosed with neonatal encephalopathy, with a General Movements Assessment done between birth to six months of life and an assessment for cerebral palsy by at least two years of age. Experimental and quasi-experimental study designs including randomized controlled trials, non-randomized controlled trials, before and after studies, interrupted time-series studies and systematic reviews will be considered. Case reports, case series, case control and cross-sectional studies will be included. Text, opinion papers and animal studies will not be considered for inclusion in this scoping review as this is a highly specific and medical topic. Studies in the English language only will be considered. Studies published from at least 1970 will be included as this is around the time when the General Movements Assessment was first introduced in neonatology as a potential predictor of neuromotor outcomes. We will search five databases (MEDLINE, Embase, PsychINFO, Scopus and CINAHL). Two reviewers will conduct all screening and data extraction independently. The articles will be categorized according key findings and a critical appraisal performed. Discussion The results of this review will guide future research to improve early identification and timely intervention in infants with neonatal encephalopathy at risk of neuromotor impairment.

scholarly journals The assessment of general movements in term and late-preterm infants diagnosed with neonatal encephalopathy, as a predictive tool of cerebral palsy by two years of age - A scoping review.

2021 ◽  
Author(s):  
Judy Seesahai ◽  
Thomas Rotter ◽  
Maureen Luther ◽  
Patricia Maddalena ◽  
Paige Terrien Church ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Negative Predictive Value ◽  
Scoping Review ◽  
Predictive Value ◽  
Late Preterm ◽  
Neonatal Encephalopathy ◽  
Late Preterm Infants ◽  
Time Period ◽  
General Movements ◽  
Sensitivity Specificity

Abstract BACKGROUND The General Movements Assessment is a non-invasive and cost-effective tool with demonstrated reliability for identifying infants at risk for cerebral palsy. Early detection of cerebral palsy allows for implementation of early intervention, and is associated with better functional outcomes. No review to date has summarized the utility of the General Movements Assessment to predict cerebral palsy in term and late-preterm infants diagnosed with neonatal encephalopathy.METHODS We conducted a scoping review involving infants born greater than or equal to 34 weeks gestational age to identify all available evidence and delineate research gaps. We extracted data on sensitivity, specificity, positive and negative predictive value and described the strengths and limitations of the results. We searched five databases (MEDLINE, Embase, PsychINFO, Scopus and CINAHL). Two reviewers conducted all screening and data extraction independently. The articles were categorized according to key findings and a critical appraisal performed.RESULTS From the electronic database search, only two studies, case series, met all of the inclusion criteria. The total number of participants were 60. Neither of the final eligible studies included late-preterm neonates. Both studies reported on sensitivity, specificity, positive predictive and negative predictive value. The newer study reported that in the time period between term and 4-5 months post-term, that any cramped synchronized movements in this time period had results of 100% sensitivity and variable results for specificity, positive predictive value and negative predictive value. Neither of the studies had infants that received therapeutic hypothermia for Neonatal Encephalopathy.CONCLUSIONS The finding of cramped synchronized General Movements is a strong predictor for the diagnosis of cerebral palsy by two years of age in the term population with neonatal encephalopathy. The deficit of high quality research limits the applicability and so the general movements assessment should not be used in isolation when assessing this population.Systematic review registrationTitle registration with Joanna Briggs Institute. URL: http://joannabriggswebdev.org/research/registered_titles.aspx

scholarly journals The assessment of general movements in term and late-preterm infants diagnosed with neonatal encephalopathy, as a predictive tool of cerebral palsy by 2 years of age—a scoping review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Judy Seesahai ◽  
Maureen Luther ◽  
Paige Terrien Church ◽  
Patricia Maddalena ◽  
Elizabeth Asztalos ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Late Preterm ◽  
Neonatal Encephalopathy ◽  
Predictive Values ◽  
Late Preterm Infants ◽  
High Negative Predictive Value ◽  
General Movements ◽  
Sensitivity Specificity

Abstract Background The General Movements Assessment is a non-invasive and cost-effective tool with demonstrated reliability for identifying infants at risk for cerebral palsy. Early detection of cerebral palsy allows for the implementation of early intervention and is associated with better functional outcomes. No review to date has summarized the utility of the General Movements Assessment to predict cerebral palsy in term and late-preterm infants diagnosed with neonatal encephalopathy. Methods We conducted a scoping review involving infants born greater than or equal to 34 weeks gestational age to identify all available evidence and delineate research gaps. We extracted data on sensitivity, specificity, and positive and negative predictive values and described the strengths and limitations of the results. We searched five databases (MEDLINE, Embase, PsychINFO, Scopus, and CINAHL) and the General Movements Trust website. Two reviewers conducted all screening and data extraction independently. The articles were categorized according to key findings, and a critical appraisal was performed. Results Only three studies, a cohort and two case series, met all of the inclusion criteria. The total number of participants was 118. None of the final eligible studies included late-preterm neonates. All three studies reported on sensitivity, specificity, and positive predictive and negative predictive values. An abnormal General Movement Assessment at 3–5 months has a high specificity (84.6–98%) for cerebral palsy with a similarly high negative predictive value (84.6–98%) when it was normal. Absent fidgety movements, in particular, are highly specific (96%) for moderate to severe cerebral palsy and carry a high negative predictive value (98%) when normal. In the time period between term and 4–5 months post-term, any cramped synchronized movements had results of 100% sensitivity and variable results for specificity, positive predictive value, and negative predictive value. Conclusions A normal General Movements Assessment at 3 months in a term high-risk infant is likely associated with a low risk for moderate/severe cerebral palsy. The finding of cramped synchronized General Movements is a strong predictor for the diagnosis of cerebral palsy by 2 years of age in the term population with neonatal encephalopathy. The deficit of high-quality research limits the applicability, and so the General Movements Assessment should not be used in isolation when assessing this population. Systematic review registration Title registration with Joanna Briggs Institute. URL: http://joannabriggswebdev.org/research/registered_titles.aspx.

scholarly journals The Assessment of General Movements in Term and Late-Preterm Infants Diagnosed with Neonatal Encephalopathy, As a Predictive Tool of Cerebral Palsy by Two Years of Age - A Scoping Review.

2020 ◽  
Author(s):  
Judy Seesahai ◽  
Thomas Rotter ◽  
Maureen Luther ◽  
Patricia Maddalena ◽  
Paige Terrien Church ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Late Preterm ◽  
Neonatal Encephalopathy ◽  
Late Preterm Infants ◽  
Spontaneous Movements ◽  
Time Period ◽  
General Movements ◽  
Sensitivity Specificity

Abstract BACKGROUND The General Movements Assessment is a non-invasive and cost-effective tool with demonstrated reliability for identifying infants at risk for cerebral palsy. Early detection of cerebral palsy allows for implementation of early intervention, and is associated with better functional outcomes. No review to date has summarized the utility of the General Movements Assessment to predict cerebral palsy in term and late-preterm infants diagnosed with neonatal encephalopathy and so detect the research gaps. METHODS We conducted a systematic scoping review for data on sensitivity, specificity, positive and negative predictive value and described the strengths and limitations of the results. We searched five databases (MEDLINE, Embase, PsychINFO, Scopus and CINAHL). Two reviewers conducted all screening and data extraction independently. The articles were categorized according key findings and a critical appraisal performed.RESULTS From the electronic database search, only two studies, case series, met all of the inclusion criteria. The total number of participants were 60. Neither of the final eligible studies included late-preterm neonates. Both studies reported on sensitivity, specificity, positive predictive and negative predictive value. The newer study reported that in the time period between term and 4-5 months post-term, that any cramped synchronized movements in this time period had results of 100% sensitivity and variable results for specificity, positive predictive value and negative predictive value. Neither of the studies had infants that received therapeutic hypothermia for Neonatal Encephalopathy. CONCLUSIONS The finding of cramped synchronized General Movements is a strong predictor of cerebral palsy by two years of age in the term population. Neonatal encephalopathy has an effect on spontaneous movements in term infants, be it transient or persistent. The predictive ability of spontaneous movements is very accurate when assessed early but improves when done later (at 15-22 weeks of age). A deficit of research exists with regards to cerebral palsy prediction using general movements in term and late-preterm infant with encephalopathy, especially when therapeutic hypothermia is instituted. Systematic review registration Title registration with Joanna Briggs Institute. URL: http://joannabriggs-webdev.org/research/registered_titles.aspx

scholarly journals Early Neurological Assessment and Long-Term Neuromotor Outcomes in Late Preterm Infants: A Critical Review

Medicina ◽  
2020 ◽  
Vol 56 (9) ◽  
pp. 475
Author(s):  
Domenico M. Romeo ◽  
Martina Ricci ◽  
Maria Picilli ◽  
Benedetta Foti ◽  
Giorgia Cordaro ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Preterm Infants ◽  
Gestational Age ◽  
Critical Review ◽  
Neonatal Period ◽  
Late Preterm ◽  
Motor Disorder ◽  
Neurological Assessment ◽  
Late Preterm Infants ◽  
Reported Data

Background and Objectives: Late preterm (LP) infants (born between 34 and 36 weeks of gestational age) are considered at higher risk of neonatal morbidities, mortality, and neurological impairments than full-term born infants (FT). The aim of this study was to provide a critical review of the literature outlining the different aspects of neurological function reported both in the neonatal period and in the follow up of late preterm infants. Materials and Methods: A comprehensive search of the MEDLINE, Embase, PsycINFO, and CINAHL electronic databases was made, using the following search terms: ‘Late preterm infants’, ‘Near term infants’, ‘neurological assessment’, ‘neurological outcome’, ‘neuromotor outcome’, cerebral palsy’, ‘CP’, ‘motor impairment’, including all the studies reporting clinical neurological assessment of LP (including both neonatal period and subsequent ages). Results: A total of 35 articles, comprising 301,495 children, were included as fulfilling the inclusion criteria: ten reported neonatal neurological findings, seven reported data about the first two years after birth, eighteen reported data about incidence of CP and motor disorder during the infancy. Results showed a more immature neurological profile, explored with structured neurological assessments, in LP infants compared with FT infants. The LP population also had a higher risk of developing cerebral palsy, motor delay, and coordination disorder. Conclusion: LP had a higher risk of neurological impairments than FT infants, due to a brain immaturity and an increased vulnerability to injury, as the last weeks of gestational age are crucial for the development of the brain.

scholarly journals The Timing of Initiating Complementary Feeding in Preterm Infants and Its Effect on Overweight: A Systematic Review

2018 ◽  
Vol 72 (4) ◽  
pp. 307-315 ◽  
Author(s):  
Karin M. Vissers ◽  
Edith J.M. Feskens ◽  
Johannes B. van Goudoever ◽  
Arieke J. Janse
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Preterm Infants ◽  
Complementary Feeding ◽  
Controlled Trial ◽  
Controlled Trials ◽  
Z Score ◽  
Term Infants ◽  
Randomized Controlled ◽  
Significant Difference

Background: What is the appropriate time to start complementary feeding for preterm infants? The answer to this question is yet under debate. The timing of initiating complementary feeding may be associated with overweight in term infants. This systematic review aimed to study the effect of the timing of initiating complementary feeding on overweight in preterm infants. Predefined search items included preterm infants, complementary feeding, overweight, and their synonyms. Summary: The search identified 15,749 articles, of which 5 articles were included. Three studies presented data of randomized controlled trials and 2 studies were cohort studies. Two randomized controlled trials found no significant difference in body mass index (BMI) Z-score between the intervention groups at 12 months of age. One randomized controlled trial presented a significant greater mean rate of growth in length per week until 12 months in the preterm weaning strategy-group compared with the current best practices. One observational study concluded that each month the infants received complementary food later, the Z-score for length and weight was reduced by 0.1. Key Messages: No clear conclusion could be drawn from the included studies. This review illustrates the need for further research to access the effect of the timing of initiating complementary feeding on overweight in preterm infants.

Sign in / Sign up

Export Citation Format

Share Document