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Aim: General movements’ assessment (GMA), based on Gestalt perception, identifies infants at risk of cerebral palsy. However, the requirement of ample experience to construct the assessor's inner criteria for abnormal movement hampers its widespread clinical use. This study aims to describe details of general movements (GMs) in various body parts and to investigate their association with GMA-Gestalt. Methods: Participants were 24 typically developing infants and 22 very-high-risk infants. GMs were assessed during the writhing (0-8 weeks) and/or fidgety GM phase (2-5 months) by GMA-Gestalt and a semi-quantification of the duration of simple movements and complex movements in various body parts. Results: During both GM phases, the quality of movement often varied within a single assessment, but the degree of complexity and variation of movements in trunk, arms and legs were interrelated (ρ = 0.32-0.84). Longer durations of complex movements in arms and legs (P

Aim To determine the prevalence of atypical general movements (GMs) in the general population, to examine its time trend and associated factors.Methods Participants consisted of 300 infants born in 2016-2018 (current cohort; gestational age 39.4 weeks (27-42); 162 boys), representative of the Dutch population. GMs were assessed at 2-4 months corrected age in terms of GM-complexity (definitely abnormal (DA) or not) and fidgety movements (present or absent). GM-complexity data from a cohort of 455 Dutch infants born in 2001-2002 were used to investigate the time trend.Results In the current cohort, 10 infants (3%) showed DA GM-complexity and 8 (3%) absent fidgety movements. Only one infant had both GM-impairments (0.3%). The prevalence of DA GM-complexity did not differ from that in the 2001-2002 cohort (adjusted odds ratio (OR) = 1.47 [0.53, 4.06]). DA GM-complexity was associated with maternal smoking (adjusted OR = 3.59 [1.56, 8.28]) and marginally with prematurity (adjusted OR = 2.78 [1.00, 7.74]); absence of fidgety movements was curvilinearly associated with assessment age only (OR = 1.06 [1.01, 1.12]).Conclusion In the general population, the prevalence of DA GM-complexity and absent fidgety movements is 3%. The finding that they rarely co-occur and are associated with different factors indicates that GM-assessment needs to address both aspects.

Aim: To determine the prevalence of prevailing head position to one side (PHP) in young infants and to evaluate its associations with reaching performance, neurological condition and perinatal and socio-economic factors. Methods: Observational study in 500 infants (273 boys) 2-6 months corrected age, representative of the Dutch population (median gestational age 39.7 weeks (27-42); birthweight 3438 g (1120-4950). Prevailing head position to one side and reaching performance were assessed with the Infant Motor Profile; neurological condition with the Standardized Infant NeuroDevelopmental Assessment. Socio-economic information and perinatal information were obtained by questionnaire and medical records. Associations were analysed with uni- and multivariable statistics. Results: Prevailing head position to one side was observed in 100 infants (20%), and its prevalence decreased from 49% at 2 months to 0% at 6 months. Only in infants aged 4-5 months PHP was significantly associated with worse reaching and an at-risk neurological score. Prevailing head position to one side was weakly associated with prenatal substance exposure, post-natal admission to a paediatric ward and paternal native Dutch background. Conclusion: Prevailing head position to one side at 2-3 months is a frequently occurring sign with limited clinical significance. Yet, PHP at 4-5 months is associated with a worse functional and neurological condition. Therefore, PHP at 4-5 months could serve as a red flag indicating possible challenges in later development.

Increased childhood blood pressure (BP) can lead to increased BP later in life and even small increases have been associated with a higher risk of adult cardiovascular disease. In contrast, lower childhood BP has been associated with more favourable health outcomes. One study found that a 2 mmHg reduction in childhood diastolic BP was associated with a 17% decrease in the prevalence of adult hypertension . This article is protected by copyright. All rights reserved.

AIM: To evaluate changes in prevalence of impaired motor coordination among six-year-olds of a geographically defined area in Germany between the years 1990 and 2007 METHODS: Data from the obligatory school entrance examinations in the German state of North-Rhine Westphalia between the years 1990 and 2007 were used. The number of children assessed per year varied from 81,517 to 124,086. The classification of impaired motor coordination was based on the combination of standardized screening and physicians clinical impression of need of treatment. Logistic regression modelling was performed to evaluate the changes in prevalence of impaired motor coordination RESULTS: Between 1990 and 2007 the prevalence of impaired motor coordination rose from 2.5% to 8.9% in boys and from 0.8% to 3.6% in girls. As the standard error of these percentages is below 0.15%, the changes are highly statistically significant. CONCLUSION: The prevalence of impaired motor coordination tripled during the last decades in North-Rhine Westphalia. This may imply that the prevalence of Developmental Coordination Disorder also increased. Factors which may explain the increasing prevalence include the increase of surviving preterm infants, increasing parental age at child birth, maternal and child obesity, and decreasing child mobility. © 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica. Language: en

Aim: To investigate the relationship between motor performance and minor neurological dysfunction (MND) at school age. Methods: Two hundred and fifty-three children (158 boys, 95 girls; mean age 8 years and 7 months) of whom 167 children received mainstream education and 86 children special education were neurologically examined according to Touwen. Special attention was paid to the severity of MND (simple or complex form) and type of dysfunction. Motor performance was assessed with the Movement Assessment Battery for Children (MABC), a parental questionnaire (Developmental Coordination Disorder Questionnaire; DCD-Q) and a teacher's questionnaire (Motor Observation Questionnaire for Teachers; MOQ-T). Results: Total scores of MABC, DCD-Q and MOQ-T were strongly related to the severity of MND and to dysfunctional coordination and fine manipulation. Mild dysfunction in posture and muscle tone was only weakly related to limited motor performance. Children with a MABC score 15th percentile (54% vs 17% and 10%). Conclusion: Limited motor performance is related to the severity and type of MND. Coordination problems and fine manipulative disability are strongly related to poor motor performance, mild dysfunctions of posture and muscle tone to a lesser extent.

Aim:During motor development, infants learn to select adaptive motor strategies out of their motor repertoire. The aim of this study is twofold: first, to investigate whether the presence of adaptive motor behaviour can be observed reliably, and second, to explore the ages at which clinically observable transition to adaptive motility emerges for four specific motor functions: abdominal progression, sitting motility, reaching and grasping.Methods:The reliability part of the study included 38 assessments of term and preterm infants in the age range of 4-18 months. The longitudinal prospective study included 30 term born typically developing infants with nine assessments between 3 and 18 months. On the basis of standardized video-recordings of spontaneous motor behaviour, the presence of adaptive motor strategies was scored.Results:Intra- and interobserver reliability were good. Clinically observable transitions to adaptive selection started to emerge from 6 months onwards and peaked between 8 and 15 months. Transitions developed gradually and occurred at specific ages for different motor functions.Conclusion:Transition to adaptive motor behaviour can be observed reliably. Adaptive motor behaviour develops gradually from 6 months onwards at function-specific ages. Comparison of our results to literature showed that changes measured by neurophysiologic methods precede clinically observed transitions.

Aim: Clinical trials on the effects of long-chain polyunsaturated fatty acids (LC-PUFA) supplementation of formula milk on growth of term and preterm children have shown conflicting results. We examined the effects of LC-PUFAs - especially docosahexaenoic acid (DHA) and arachidonic acid (AA) - on growth at 18 months.Methods: We performed a meta-analysis based on individual patient data (IPD) of 901 children from four large, randomised clinical trials of formula milk with and without LC-PUFAs. Anthropometrics were assessed by z-scores based on weight for age, length for age, head circumference for age and body mass index (BMI) for age at 18 months. The studies differed in LC-PUFA composition and infant characteristics (two studies on preterm children, two on term children).Results: Multivariate regression analyses including the possible confounders, sex, gestational age, birth weight, smoking in the last trimester and maternal age, as well as interaction terms showed no significant effects of LC-PUFA supplementation on any z-score. Subgroup analyses on trials with high amounts of DHA and on studies with duration of supplementation of at least 6 months yielded the same result. These findings cannot be explained by the lack of power.Conclusion: Our IPD meta-analysis shows no evidence that LC-PUFA supplementation affects children's growth at 18 months of age.

Aim: Previously, we found a beneficial effect of 2 mo supplementation of infant formula with long-chain polyunsaturated fatty acids (LC-PUFA) on neurological condition at 3 mo in healthy term infants. The aim of the present follow-up study was to evaluate whether the effect on neurological condition persists until 18 mo. Methods: A prospective, double-blind, randomized control study was conducted. Three groups were formed: a control (CF; n = 169), an LC-PUFA-supplemented (LF; n = 146) and a breastfed (BF; n = 159) group. Information on potential confounders was collected at enrolment. At the age of 18 mo, neurodevelopmental condition was assessed by the age-specific neurological examination of Hempel and the Bayley scales. The Hempel assessment resulted in a clinical neurological diagnosis, a total optimality score and a score on the fluency of motility. The Bayley scales resulted in mental and psychomotor developmental indices. Attrition at 18 mo was 5.5% and non-selective. Multivariate regression analyses were carried out to evaluate the effect of type of feeding while adjusting for confounders. Results: None of the children had developed cerebral palsy and 23 (CF: n = 83 LF: n = 10; BF: n = 5) showed minor neurological dysfunction. The groups did not show statistically significant differences in clinical neurological condition, neurological optimality score, fluency score, and the psychomotor and mental development indices. Multivariate analysis confirmed that there was no effect of type of feeding on neurological condition. Conclusion: This study indicates that the beneficial neurodevelopmental effect of 2 mo LC-PUFA supplementation in healthy term infants can not be detected at the age of 18 mo.