General movements of preterm newborns in a neonatal unit and warning signs at hospital discharge: a correlational study

Authors

DOI:

https://doi.org/10.17267/2238-2704rpf.2026.e6479

Keywords:

Child Development, Prematurity, Neonatal Intensive Care Unit

Abstract

INTRODUCTION: Preterm newborns (PTNBs) require increased care and often need admission to Neonatal Intensive Care Units (NICUs), where they undergo various invasive procedures. These infants must be assessed and monitored until hospital discharge. OBJECTIVES: To correlate data obtained from the assessment of General Movements (GMs) with the Valoración Al Alta de Neonatología alert signs scale in preterm infants born in a public referral hospital. METHODOLOGY: After obtaining informed consent from the guardians, data from electronic medical records were evaluated and the scales were applied up to 48 hours before discharge. Statistically comparative analyses and the t-test were used to assess the correlation of the data. All infants with legally mandated custody were excluded. RESULTS: The sample consisted of 12 babies, of whom 3 were excluded. Among eligible participants, the most prevalent altered warning sign was cervical tone. In the GMs, complexity was positively associated with infants exhibiting fewer altered warning signs. CONCLUSION: GM complexity showed the most consistent association with adequate neurological signs, demonstrating the effectiveness of both GMs and alert signs and reinforcing the combined usefulness of these assessments for early neurodevelopmental screening in preterm infants.

Downloads

Download data is not yet available.

References

1. Bradley E, Blencowe H, Moller AB, Okwaraji YB, Sadler F, Gruending A, et al. Born Too Soon: Global epidemiology of preterm birth and drivers for change. Reprod Health. 2025;22:105. https://doi.org/10.1186/s12978-025-02033-x

2. Ohuma E, Moller AB, Bradley E, Chakwera S, Hussain-Alkhateeb L, Lewin A, et al. National, regional, and global estimates of preterm birth in 2020, with trends from 2010: a systematic analysis. Lancet. 2023;402(10409):1261-71. https://doi.org/10.1016/S0140-6736(23)00878-4

3. Matoba N, Kim C, Branche T, Collins JW. Social determinants of preterm birth. Clin Perinatol. 2024;51:33-43. https://doi.org/10.1016/j.clp.2024.02.002

4. Toneli LS, Silva MB, Pinto AAM, Queiroz FC, Queiroz LMP. Influence of biopsychosocial factors on the development of preterm and full-term infants. Res Soc Dev. 2024;13:e11113345370. https://doi.org/10.33448/rsd-v13i3.45370

5. Cheong JLY, Burnett AC, Treyvaud K, Spittle AJ. Early environment and long-term outcomes of preterm infants. J Neural Transm. 2020;127:1-8. https://doi.org/10.1007/s00702-019-02121-w

6. Chaves BF, Gerzson LR, Almeida CS. Comparison of neurological assessment and general movements of at-risk babies with 40 and 52 weeks of life from a public hospital of reference in the maternal-infant area. Movimenta. 2022;15(3):e20220032. https://doi.org/10.31668/movimenta.v15i3.13287

7. Boas FPV, Costa MGR, Borges RM, Martins CDC, Stopa GO, Vieira TDO, et al. Prevalência de infecções e de terapia intensiva neonatal. Braz J Infect Dis. 2023;27:103219. https://doi.org/10.1016/j.bjid.2023.103219

8. Govaert P, Arena R, Dudink J, Steggerda S, Agut T, Marissens G, et al. Developmental anatomy of the thalamus, perinatal lesions, and neurological development. Dev Med Child Neurol. 2025;67:15–34. https://doi.org/10.1111/dmcn.15992

9. Clowry GJ. Is there a consensus on the location and composition of the human subplate? J Comp Neurol. 2024;532:e25605. https://doi.org/10.1002/cne.25605

10. Wu Y-C, Straathof EJM, Heineman KR, Hadders-Algra M. Typical general movements at 2–4 months: movement complexity, fidgety movements, and their associations with risk factors and SINDA scores. Early Hum Dev. 2020;149:105135. https://doi.org/10.1016/j.earlhumdev.2020.105135

11. Hadders-Algra M. Early diagnosis and early intervention in neurodevelopmental disorders: age-dependent challenges and opportunities. J Clin Med. 2021;10:861. https://doi.org/10.3390/jcm10040861

12. Martins KP, Freire MHDS, Pechepiura EP, Lage SDM, Saganski GF. Care and development of the premature infant in a neonatal intensive care unit: a scoping review. REME Rev Min Enferm. 2021;25:e20210062. https://doi.org/10.5935/1415.2762.20210062

13. García-Alix A, Arnáez J. Neurología neonatal de un vistazo. 1ª edição. Madrid: Cabeza de Chorito; 2022.

14. Morinel CS, Almeida CSD, Gerzson LR. Comparison of neurological assessment and general movements of infants at risk at different time points. Fisioter Bras. 2024;24:751–69. https://doi.org/10.33233/fb.v24i6.5434

15. Hadders-Algra M. General movements: a window for early identification of children at high risk for developmental disorders. J Pediatr. 2004;145(Suppl 2):S12–8. https://doi.org/10.1016/j.jpeds.2004.05.017

16. Alberton M, Rosa VM, Iser BPM. Prevalence and temporal trend of prematurity in Brazil before and during the COVID-19 pandemic: a historical time series analysis, 2011–2021. Epidemiol Serv Saude. 2023;32:e2022603. https://doi.org/10.1590/s2237-96222023000200005

17. Dassios T, Harris C, Williams EE, Greenough A. Sex differences in preterm respiratory morbidity: a recent whole population study. Acta Paediatr. 2024;113:745–50. https://doi.org/10.1111/apa.17071

18. Dondé JP, Soncini TCB, Nunes RD. Fatores associados ao baixo índice de Apgar no quinto minuto de vida em recém-nascidos. Rev. Arq Catarin Med. 2020;49:69–80. https://doi.org/10.63845/2err4z87

19. Silva B, Friedrich L, Biazus G, Bueno R, Almeida C. Abnormal neurological and motor function in newborns treated for congenital syphilis. Infect Dis Rep. 2025;17:34. https://doi.org/10.3390/idr17020034

20. Yu WH, Chu CH, Chen LW, Lin YC, Koh CL, Huang CC. The developmental phenotype of motor delay in extremely preterm infants after early respiratory adversity is influenced by parietal lobe brain dysmaturation. J Neurodev Disord. 2024;16:38. https://doi.org/10.1186/s11689-024-09546-9

21. Gada S, editor. Neurodisability and community child health. 2nd ed. Oxford: Oxford University Press; 2022. p. 29–88. https://doi.org/10.1093/med/9780198851912.003.0002

22. Bresciani EP, Aere DG, Camargo KG, Esposito NCO, Santos DCC. Evaluation of cervical control in preterm infants

after discharge from neonatal intensive care unit. Movimenta [Internet]. 2020;26:389–99. Available from: https://www.revista.ueg.br/index.php/movimenta/article/view/10812

23. Krynauw R, du Preez JCF, van Zyl JI, Burger M. The trajectory of general movements from birth to 12–14 weeks corrected age in very low and extremely low birth weight preterm infants. S Afr J Child Health. 2022;16:99–104. https://doi.org/10.7196/SAJCH.2022.v16i2.1893

24. Zlatanovic D, Čolović H, Živković V, Stanković A, Kostić M, Vučić J, et al. The importance of general movement assessment in preterm infants for the prediction of neurological outcomes. Folia Neuropathol. 2022;60:427–35. https://doi.org/10.5114/fn.2022.119593

25. Christovão IS, Rodrigues LA, Machado ACCP, Pascoal AFS, Fontes DE, Mendonça KTD, et al. Hybrid follow-up of preterm infant development in Brazil: a feasibility study. Early Hum Dev. 2024;195:106069. https://doi.org/10.1016/j.earlhumdev.2024.106069

Published

03/17/2026

Issue

Section

Original Articles

How to Cite

1.
Saballa GS, da Rosa MF, de Almeida CS. General movements of preterm newborns in a neonatal unit and warning signs at hospital discharge: a correlational study. Rev Pesq Fisio [Internet]. 2026 Mar. 17 [cited 2026 Mar. 17];16:e6479. Available from: https://journals.bahiana.edu.br/index.php/fisioterapia/article/view/6479