Fidgety Movement Classification in Preterm Infants Without Major Structural Brain Abnormalities: Associations with Gestational Age, Birth Weight, and Neonatal Morbidity.

Background/Objectives: Fidgety movements are established markers of early neurological function in preterm infants. However, associated biological and neonatal factors remain insufficiently understood, particularly in infants without major structural brain abnormalities. This study aimed to compare biological maturity and neonatal morbidity in infants with normal, abnormal, and absent fidgety movements. Methods: Prospectively collected data from 57 preterm infants assessed at 12-16 weeks corrected age using Prechtl's General Movements Assessment were analysed. Infants with moderate or severe abnormalities on term-equivalent magnetic resonance imaging were excluded. Gestational age, birth weight, clinically significant morbidities, a cumulative morbidity count, and durations of non-invasive respiratory support and mechanical ventilation were compared by fidgety movement classification. Results: Significant overall differences were found for gestational age (p = 0.018), birth weight (p = 0.027), non-invasive respiratory support (p = 0.014), and mechanical ventilation (p = 0.016). Infants with absent fidgety movements had lower gestational age (mean difference, 2.6 weeks; adjusted p = 0.021), lower birth weight (mean difference, 386 g; adjusted p = 0.021), longer non-invasive respiratory support (adjusted p = 0.014), and longer mechanical ventilation (adjusted p = 0.019) than infants with abnormal fidgety movements. Comparisons involving infants with normal fidgety movements were not significant. Individual morbidities and the cumulative morbidity count also did not differ by classification. Conclusions: Biological maturity and respiratory-treatment duration differed according to fidgety movement classification. However, the observed pattern did not indicate a simple ordinal relationship between the examined clinical characteristics and normal, abnormal, and absent fidgety movements.