66 - Comparison of patterns and trajectories of general movements between late preterm and term babies with and without fetal growth restriction

Publication Number: 2063.66

Abhishek Pratap. Singh, Pratiksha rainbow children’s hospital,guwahati, Guwahati, Assam, India; arti &DR. maria, ABVIMS, Delhi, Delhi, India

Background: Fetal growth retardation (FGR) is a pathological condition ,characterized by impairment of fetal growth and development in utero. IUGR plays an important role in the neurodevelopmental outcome. The qualitative assessment of the general movements provides an insight into the maturation of the CNS and is thus is predictive of neurodevelopmental outcomes in both preterm and term neonates

Objective: To compare the pattern and trajectory of general movements among late preterm and term babies with and without FGR at 40-44 weeks PMA and 3-5 months corrected age.

Design/Methods: This prospective analytical observational study was conducted from 1st Jan 2023 to 30th September 2023 in the Department of Neonatology of a tertiary care hospital.Late preterm and term infants with FGR, and gestation-matched controls without FGR, General movements were assessed through two video recordings: one at 40-44 weeks PMA and another at 3-5 months corrected age.All the enrolled infants were followed up at 40-44 weeks of post-menstrual age (PMA) and 3-5 months of corrected age for general movement assessment and neurological examination using HNNE and HINE, respectively.

Results: Of the 1321 infants assessed for eligibility, 1221 were excluded.A total of 100 infants were enrolled, with 50 in each group. At 40-44 weeks, 39 (78%) of FGR infants exhibited normal general movements, while 10 (20%) showed poor repertoire movements. In contrast, 49 of 50 non-FGR infants had normal general movements.At 3-5 months corrected age, 47 of 50 FGR infants and 46 of 50 non-FGR infants demonstrated normal fidgety movements..All the seven infants with antenatal doppler abnormalities had poor repertoire at 40-44 weeks of PMA(table-4).All enrolled infants underwent the HNNE at term-equivalent age (40-44 weeks) and the HINE at 3-5 months corrected age.Both HNNE and HINE were significantly lower in the FGR group (p < 0.001) (Table -5).

Conclusion(s): .This study highlights a higher incidence of abnormal general movements at term-equivalent age in FGR infants, particularly in late preterm FGR infants. This finding may be attributed to chronic oxygen and nutrient deprivation in utero, which can result in transient brain dysfunction. Our results also show that infants with abnormal GMs frequently had abnormal antenatal Doppler findings. Furthermore, lower HNNE and HINE scores were observed in infants with FGR. Larger studies with longer follow-up are needed to confirm the impact of FGR and abnormal GMs at term-equivalent age on long-term cognitive and neurodevelopmental outcomes.

Table 1-Demographic characteristics,Table 2-Anthropometric and nutritional status scoring of the study population
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Baseline characteristic (N100)
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Table 4- General Movements in the admitted IUGR and Non IUGR neonates,Table 5- Neurological Examination score in IUGR neonates and Non IUGR neonates
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