Background: Early interventions in high-risk children seek to improve prognosis, minimize developmental delays, and prevent functional deterioration. The objective of this study was to evaluate the level of agreement between the face-to-face assessment and tele-assessment of neuromotor development in high-risk children between 0 and 18 months of age. Methods: Forty-five children at high risk of developmental delays were included in this study (33% female, mean gestational age of 35.31 ± 4.03 weeks). The patients were included in a face-to-face and a tele-assessment using the Alberta Infant Motor Scale (AIMS) and the level of motor evolution (Niveaux d’Évolution Motrice, NEM) assessments. Results: The analysis showed excellent interrater reliability (ρ ≥ 0.99) for the AIMS. The NEM assessment showed almost perfect reliability (kappa ≥ 0.81) for most items. Seven of them showed substantial reliability (kappa = 0.61–0.80), one moderate reliability (kappa = 0.568), and one fair reliability (kappa = 0.338). Conclusions: This study reveals an excellent/substantial interrater reliability for most of the items assessed. The results are promising to increase the accessibility to a clinical diagnosis and a rehabilitation approach to minimize the development of neuromotor delays in children at high risk.

Objective. To evaluate serum neuronal and inflammatory biomarkers in asphyctic newborns treated with hypothermia alone or hypothermia plus melatonin, and whether biomarkers correlate with neurodevelopmental outcomes. Design. This is a pilot multicentre, randomised, controlled, double blind clinical trial. Neuronal glial fibrillary acidic protein (GFAP), granulocyte-macrophage colony-stimulating factor (GM-CSF), and inflammatory cytokines (interleukin (IL)-1, IL-2, IL-7 and IL-13) were measured in serum samples at hospital admission (T0), 24 hours (T1), 72 hours (T2) and 7-10 days of age (T3). Neurodevelopmental outcomes (Bayley Scales of Infant and Toddler Development-III scales, Gross Motor Function Classification System (GMFCS) and the Tardieu scale) were performed at 6 and 18 months. Setting: Level 3 neonatal intensive care unit. Patients and interventions: 25 newborns were recruited. The treated patients received a daily dose of intravenous melatonin, 5 mg per kg body weight, for 3 days. Results. After adjusting the data for severity, in the group treated with melatonin, there is a decrease in plasma levels of GM-CSF, IL-2 and IL-13 at T1 compared to placebo, as well as, at T2, in GM-CSF concentrations, as well as IL-7 and IL-13 at T3. Evolutionarily, we found a significant decrease in GM-CSF concentrations in the treatment group compared to placebo, with no differences for the rest of the biomarkers. It is noteworthy that the sustained decrease in GM-CSF and inflammatory cytokines IL-2, IL-7 and IL-13 correlated with better neurodevelopmental outcomes at 6 and 18 months. Conclusions. In neonates with hypoxic-ischemic encephalopathy, the addition of iv melatonin to hypothermia therapy affects the plasma concentration of biomarkers in the first week of life, with a high correlation with long-term neurological prognosis.