Seventeen studies with total of 1,926 participants were included in the review: 1,728 (89.7%) were preterm and 198 (10.3%) were full term. Two studies included only full-term infants, 11 studies included only preterm infants and nine studies included only high-risk infants.
The mean quality score of the included studies was 8.82 (standard deviation 0.73). No study fulfilled the criterion of no biases introduced into the study and no study described reliability of neurodevelopmental assessments used as the reference standard to determine neurological outcomes. Only one study reported on validity of the neurodevelopmental assessments used.
Five studies assessed a total of total 285 infants at 12 months corrected age: 42 were lost to follow-up; 105 were assessed as normal; 40 had mild neurological deficits; and 34 had severe neurological deficits (cerebral palsy).
Twelve studies evaluated a total of 1,742 infants at 24 months corrected age: eight were lost to follow-up; 1,243 were assessed as normal; 214 had mild neurological deficits; and 277 had severe neurological deficits (cerebral palsy).
Thirteen studies calculated the sensitivity and specificity of general movements in predicting neurological outcomes of infants at 12 or 24 months of age. Eight of these studies reported data for two or more of the different key age periods after birth and five found that the sensitivity and specificity values from the pre-term and/or term period increased and reached a maximum at eight to 20 weeks post-term (fidgety movements’ period). Sensitivity of general movements at eight to 20 weeks to predict neurological deficit at 12 to 24 months ranged from 50% to 100% (13 studies); specificity ranged from 35% to 100% (13 studies).
Four studies assessed correlation between general movements during the fidgety movements’ period and neurodevelopmental outcome at 12 and 24 months corrected age and all found a high correlation (p<0.01).
Data were also reported on the predictive value of general movements, as well as traditional neurological assessments and neuroimaging techniques.