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Abstract Details

Utility of General Movement Assessment (GMA) in predicting the neurodevelopmental outcomes of term and late preterm infants exposed to severe hyperbilirubinemia in the neonatal period
Child Neurology and Developmental Neurology
P9 - Poster Session 9 (5:30 PM-6:30 PM)
6-003

General Movements (GMs), the spontaneous early motor repertoire of an infant, have emerged as an important diagnostic tool for predicating future  risk of Cerebral Palsy (CP) in high risk infants(1). GMA requires only a video recording of the infant in appropriate circumstances and is a quick, non-invasive method of assessment without imposing any significant financial burden and any kind of physical contact.

Neonatal hyperbilirubinemia leading to dyskinetic CP is still a major health issue in developing countries. Proper systematic studies with a reliable follow up for determining outcomes of severe hyperbilirubinemia are still scarce. There is no systematic study of GMs till date on infants exposed to hyperbilirubinemia.

 

We studied infants exposed to severe hyperbilirubinemia in the neonatal period and assessed their General Movements (GMs) and evaluated their ability to predict future neurodevelopment.

Term and late preterm infants exposed to severe hyperbilirubinemia (Peak Total Serum Bilirubin equal or above 20 mg/dl or Peak TSB above Exchange transfusion levels as per guidelines by American Academy of Pediatrics) in the initial 2 weeks of life were recruited and GMA (General Movement Assessment) were done at appropriate ages by two independent blinded certified GMA reviewers. Neurodevelopmental Outcomes were assessed on basis of neurological examination and DASII (Development Assessment Scale for Indian Infants) at 1 year of age.

Out of 44 infants, 8 had abnormal fidgety (Absent and/or Abnormal) and rest had normal fidgety GMs. All infants with abnormal fidgety GMs had adverse neurodevelopmental outcomes (7 developed CP (Cerebral Palsy) and 1 had developmental delay), and out of rest 36 infants, 33 were normal at 1 year of age, and 3 had isolated mild developmental delay.

 

 

GMA was found to have high excellent predictive value for predicting neurodevelopment and occurrence of dyskinetic CP in this specialized population of neonates exposed to severe hyperbilirubinemia.

Authors/Disclosures
Chandana Bhagwat, MD (402 Indranil Alto )
PRESENTER
Dr. Bhagwat has nothing to disclose.
Lokesh Saini, DM (AIIMS Jodhpur) Dr. Saini has nothing to disclose.
Arushi Gahlot Saini, MD, MBBS, DM (Pgimer) Dr. Saini has nothing to disclose.
Naveen Sankhyan, MD, MBBS, DM (APC, PGIMER) The institution of Dr. Sankhyan has received research support from PTC Therapeutics for a Multicentric RCT. Dr. Sankhyan has received research support from Institute Grant, PGIMER, (Goverment Entity).
Praveen Kumar, MD Dr. Kumar has nothing to disclose.
Rajni Sharma (Post Graduate Institute of Medical Education and Research) Dr. Sharma has nothing to disclose.
Christa Einspieler, PhD (Medical University of Graz) Prof. Einspieler has received publishing royalties from a publication relating to health care.