Writhing Movements and Hypoglycemia in Moderate-Late Preterm Infants: A Prospective Cohort Study

Introduction: This study aims to examine the relationship between hypoglycemia and general movement patterns during the early post-term-aged in moderate-to-late preterm infants and to assess the interobserver reliability of movement evaluation during this period. Compared with full-term infants, moderate-to-late preterm infants constitute the largest group of premature births globally and are at greater risk of developing neurodevelopmental disorders. Hypoglycemia is one of the most prevalent risk factors in this group. Methods: This prospective single-center explorative cohort study included moderate-to-late preterm infants during their admission in the neonatal intensive care unit. General movements were assessed via Prechtl's General Movements Assessment, and blood glucose levels were monitored via the FreeStyle Optium (TM) Neo glucometer. Associations were analyzed via Fisher's exact test, whereas interobserver reliability was evaluated via the intraclass correlation coefficient (ICC) and the kappa coefficient. Results: A total of 17 moderate-to-late preterm infants with hypoglycemia (<45 mg/dL) presented a relatively high percentage (58.8%) of poor repertoire and normal (35.2%) general movement patterns during the early post-term-aged. Interobserver reliability was good (ICC = 0.7), and the kappa coefficient indicated moderate reliability (0.4). Conclusions: Moderate-to-late preterm infants with transient hypoglycemia may frequently display poor repertoire movement patterns, highlighting the need for careful monitoring. Furthermore, the evaluation of general movements proves to be a reliable tool during the early post-term-aged.