Can the Prechtl method for the qualitative assessment of general movements be used to predict neurodevelopmental outcome, at eighteen months to three years, of infants born preterm?

Abstract

Background: Preterm infants are more at risk of atypical neurodevelopment and diagnosis of impairment often occurs later in life. The Prechtl method for the qualitative assessment of general movements has been found to predict neurodevelopmental outcome in full term infants. Despite this, it is not clear whether the Prechtl assessment is predictive of neurodevelopmental outcome when used for preterm infants. Objectives: To review the literature regarding the use of the Prechtl method for the qualitative assessment of general movements in predicting neurodevelopmental outcome, at eighteen months to three years, of infants born preterm. Methods: A systematic search of MEDLINE, CINAHL, Science Citation Index, PsycINFO, Science Direct, Scopus, Social Sciences Index, Education Source, ERIC, SPORTDiscus, SciELO and SocINDEX was conducted in November 2015. The methodological quality of the included studies was critically appraised using a modified version of the Downs and Black quality index. Results: Five articles met the inclusion criteria. The Prechtl method of assessment was found to be predictive of both neuromotor and cognitive impairments at eighteen months to three years. The writhing period was found to have higher sensitivity but lower specificity and correlation to neurodevelopmental outcomes compared to the fidgety period. Combining both periods of assessment led to higher predictive power. The assessment was also found to be more predictive of severe impairment as opposed to minor impairment. Conclusions: The results of this systematic review suggest that Prechtl method of assessment can be used to predict neurodevelopmental outcome in preterm infants.