Clinical factors associated with abnormal general movements of preterm newborns during hospitalization in a neonatal intensive care unit.

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From: Early Human Development(Vol. 174)
Publisher: Elsevier B.V.
Document Type: Report
Length: 490 words

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Keywords Preterm newborns; General movements; Neonatal intensive care unit Highlights * Most infants showed one abnormal GMs during hospitalization. * PIVH grades I-II increase the chance of abnormal GMs. * Duration of mechanical ventilation increases the chance of abnormal GMs. * Non-invasive ventilatory support increases the chance of abnormal GMs. Abstract Introduction There is no clarity about which clinical variables during hospitalization in the Neonatal Intensive Care Unit (NICU) are associated with abnormal General Movements (GMs). Objective To describe the trajectory of GMs of preterm newborns and explore the association between clinical variables and the presence of abnormal GMs during the NICU stay. Methods Fifty-eight preterm newborns (33 males), with a mean gestational age at birth of 31,93 week's postmenstrual age, were evaluated using the GMs assessment by Hadders-Algra method. Clinical variables recorded weekly throughout the hospitalization period. The weekly association between clinical variables and the presence of abnormal GMs was tested using the Generalized Estimating Equations (GEE) model. Results Preterm infants were recorded for up to sixteen weeks and more than half of the infants (56.9 %) had abnormal movements in at least one week during hospitalization. The absence of peri-intraventricular hemorrhage (PIVH) grades I-II and non-invasive ventilatory support and/or oxygen therapy on the day of the evaluation reduced, respectively, by 77.3 % (OR = 0.23; p 0.0001) and 64.3 % (OR = 0.36; p 0.0001) the chance of having an abnormal classification. In addition, each day of increased invasive mechanical ventilation increased the chance of having an abnormal classification by 1.11 times (OR = 0.025; p 0.0001). Conclusion PIVH grades I-II, longer durations of mechanical ventilation and the presence of non-invasive ventilatory support and/or oxygen therapy are associated with abnormal movements during stay in the neonatal period. The data suggest that development outcome of infants having these conditions should be closely monitored. Abbreviations GMs, general movements; NICU, neonatal intensive care unit; GEE, generalized estimating equations; PIVH, peri-intraventricular hemorrhage; OR, odds ratio; CP, cerebral palsy; NBRS, neurobiological risk score; PMA, postmenstrual age; HC-UFMG, Hospital das Clínicas, Universidade Federal de Minas Gerais; SNAPPE-II, score for neonatal acute physiology with perinatal extension II; CPAP, continuous positive airway pressure; NIPPV, nasal intermittent positive pressure ventilation; CRP, C-reactive protein Author Affiliation: (a) Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (b) Graduate Program in Health, Society and Environment and Department of Physiotherapy, Universidade Federal do Vale do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil * Corresponding author at: EEFFTO - Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais (UFMG), Av. Pres. Antônio Carlos, 6627 Campus -- Pampulha, 31270-901 Belo Horizonte, Minas Gerais, Brazil. Article History: Received 20 May 2022; Revised 22 August 2022; Accepted 27 September 2022 Byline: Karoline Tury de Mendonça (a), Fernanda Córdoba Lanza (a), Rosane Luzia de Sousa Morais (b), Ana Cristina Resende Camargos [] (a,*)

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Gale Document Number: GALE|A723925867