Qualitative assessment of general movements high-risk preterm infants with chronic lung disease requiring dexamethasone therapy

A. F. Bos*, A. Martijn, R. M. Van Asperen, M. Hadderes-Algra, A. Okken, H. F.R. Prechtl

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

57 Citations (Scopus)

Abstract

Objective: The objective of this study was to determine in preterm infants at risk for severe chronic lung disease (1) the quality of general movements (GMs) and (2) the effect of dexamethasone treatment on spontaneous motor activity. Study design: In 15 very low birth weight infants the quality, of GMs was assessed from repeated videotape recordings. Recordings were made at weekly intervals during the preterm period until term age and thereafter three times until the twentieth postterm week. All infants required dexamethasone therapy, and additional recordings were made a few hours before and 24 hours, 48 hours, and 7 days after dexamethasone was started. The relationship among movement quality, brain ultrasonographic abnormalities, and long-term outcome was explored. Acute effects of dexamethasone on motor activity were examined. Results: After dexamethasone therapy was started, a significant transient reduction of the quantity of most spontaneous movements (p < 0.05) and a reduction of speed and amplitude of GMs was found (p < 0.05). A significant relation- ship was found between the severity of brain ultrasonographic abnormalities and the extent to which developmental trajectories of GMs were abnormal (p< 0.001). The development of cerebral palsy was related to the presence of cramped-synchronized movements near term (p < 0.02) and to the absence of fidgety movements at the age of 3 months after term (p < 0.05). Conclusion: In preterm infants with severe chronic lung disease and brain lesions, dexamethasone treatment leads to an acute reduction in motility and changes in the speed anti amplitude of CMs. Until more is know about long term neurologic sequelae, a cautious use of systemic dexamethasone therapy in preterm infants is recommended.

Original languageEnglish
Pages (from-to)300-306
Number of pages7
JournalJournal of Pediatrics
Volume132
Issue number2
DOIs
Publication statusPublished - 1 Jan 1998

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