The General Movements Assessment requires extensive training. As an alternative, a novel automated movement analysis was developed and validated in preterm infants. Infants < 31 weeks’ gestational age or birthweight ≤ 1500 g evaluated at 3–5 months using the general movements assessment were included in this ambispective cohort study. The C-statistic, sensitivity, specificity, positive predictive value, and negative predictive value were calculated for a predictive model. A total of 252 participants were included. The median gestational age and birthweight were 27^4/7 weeks (range 25^6/7–29^2/7 weeks) and 960 g (range 769–1215 g), respectively. There were 29 cases of cerebral palsy (11.5%) at 18–24 months, the majority of which (n = 22) were from the retrospective cohort. Mean velocity in the vertical direction, median, standard deviation, and minimum quantity of motion constituted the multivariable model used to predict cerebral palsy. Sensitivity, specificity, positive, and negative predictive values were 55%, 80%, 26%, and 93%, respectively. C-statistic indicated good fit (C = 0.74). A cluster of four variables describing quantity of motion and variability of motion was able to predict cerebral palsy with high specificity and negative predictive value. This technology may be useful for screening purposes in very preterm infants; although, the technology likely requires further validation in preterm and high-risk term populations.

Background: Caregiver and healthcare provider perspectives of virtual care have not been explored in depth in the literature for neonatal follow-up clinics. Our objective was to evaluate caregivers’ and healthcare providers’ perspectives and compare neurodevelopmental outcomes of preterm neonates before and after implementing virtual care during the SARS-CoV-2 pandemic. Methods: Semi-structured interviews were conducted with families and healthcare providers, designed and analyzed using phenomenological qualitative methods. A retrospective cohort study was conducted to evaluate and compare neurodevelopmental characteristics of two preterm cohorts, one before (“in-person”) and after (“virtual”) virtual care. Results: Three themes were identified: increased confidence in in-person assessments, adequate delivery of information using virtual platforms and a preference for specialized care through the neonatal follow-up clinic. A total of 252 infants born preterm, 104 infants in the in-person group and 148 infants in the virtual group, were included in the study. The adjusted odds ratio (aOR) of cerebral palsy was lower when virtual care was used compared to in-person assessments (aOR = 0.11, 95% CI 0.01–0.98) while the adjusted odds of cognitive delay measured by in-person standardized testing were higher (aOR = 2.78, 95% CI 1.25–6.19). Conclusions: Caregivers and healthcare providers prefer in-person assessments for comprehensive developmental support. It may be more challenging to detect subtle cognitive differences using caregiver-reported measures. Cerebral palsy may be missed when assessments are completed virtually.

Purpose: Children born very preterm often experience difficulties in academic performance at school entry, which may persist and affect long-term outcomes. Few studies have examined school readiness among children born very preterm, and routine follow-up to school age is uncommon. This study aims to describe school readiness in very preterm children and assess associations between neurodevelopmental outcomes at 18–24 months corrected age and later school readiness. Methods: This study included 112 children born <29 weeks’ gestation in Ontario, Canada (birth years 2009 and 2012), who completed the assessments of the Bayley Scales of Infant and Toddler Development, 3rd edition (BSID-III) at 18–24 months corrected age. Deterministic linkage connected BSID-III results with the Early Development Instrument (EDI), a kindergarten teacher-completed measure of school readiness. Vulnerability—defined as scores below the 10th percentile—was compared between the very preterm cohort and their Ontario peers and between children with and without neurodevelopmental impairment at 18–24 months. Results: Children born very preterm were more than twice as likely to be vulnerable in two or more EDI domains compared with their Ontario peers (34% vs. 14%). Those with neurodevelopmental impairment at 18–24 months showed higher vulnerability across all domains. Notably, 35% of children without neurodevelopmental impairment still demonstrated vulnerability at school entry. Lower BSID-III language scores were associated with vulnerability in physical health and wellbeing, language and cognitive development, and communication skills and general knowledge. Conclusion: Very preterm children, especially those with early neurodevelopmental impairment, were at increased risk for vulnerability across all areas of school readiness. Attention to early language development may help improve later school readiness outcomes.