Predictive value of general movements assessment and test of infant motor performance for neurodevelopmental outcomes in infants with severe hyperbilirubinemia
Chen Xiaolan, Du Bang, Liang Weijing, et al
Department of Neonatology, Dongguan Children’s Hospital Affiliated to Guangdong Medical University, Dongguan, Guangdong 523325, China
Objective To explore the predictive value of General Movements Assessment (GMA) and Test of Infant Motor Performance (TIMP) for the neurodevelopmental outcomes in infants with severe hyperbilirubinemia. Methods A retrospective analysis was conducted on clinical data and follow-up outcomes of 160 infants with severe hyperbilirubinemia admitted to Dongguan Children's Hospital Affiliated to Guangdong Medical University from September 2021 to December 2024. The predictive performance of GMA and TIMP for cerebral palsy was analyzed and compared with the classic assessment tools for severe hyperbilirubinemia, such as Bilirubin-Induced Neurologic Dysfunction (BIND) score and Automated Auditory Brainstem Response (AABR)/Auditory Brainstem Response (ABR). Potential risk factors for adverse neurodevelopmental outcomes were also explored using univariate analysis. Statistical analyses were performed using the independent samples t-test, rank-sum test, χ2 test and Fisher exact probability
method. The predictive value of GMA and TIMP for cerebral palsy was assessed using predictive validity,
sensitivity, specificity, positive predictive value, and negative predictive value. Results Among the 160
infants, 157 cases (98.1%) had normal neurodevelopment, 2 cases (1.3%) were diagnosed with cerebral palsy, and 1 case (0.6%) showed mild neurological impairment. In terms of predictive performance, the accuracy and specificity of GMA (77.2%, 76.4%) and TIMP (79.2%, 78.7%) were lower than those of the BIND score (93.0%, 94.5%) and AABR/ABR (88.9%, 88.5%). All four methods achieved negative predictive values above 98%, while positive predictive values ranged only from 9% to 25%. Although the sensitivities of GMA, TIMP, and AABR/ABR reached 100%, which was higher than the sensitivity of the BIND score (50%), their 95% CI were extremely wide. Univariate analysis showed that compared with the normal outcome group, the adverse outcome group had significantly lower gestational age, higher total peripheral white blood cell count, greater proportion of severe hyperbilirubinemia and abnormal GMA finds (all P<0.05). Conclusions In infants with severe hyperbilirubinemia, GMA, TIMP, BIND score and AABR/ABR all show high specificity and negative predictive values, but low positive predictive values, indicating that they are better suited for ruling out cerebral palsy. The very small number of cerebral palsy cases yields extremely wide 95% CI for sensitivity, so these findings should be interpreted cautiously.
[J]. 发育医学电子杂志, 2026, 14(5): 369-375,397.
Chen Xiaolan, Du Bang, Liang Weijing, et al.
Predictive value of general movements assessment and test of infant motor performance for neurodevelopmental outcomes in infants with severe hyperbilirubinemia
. Journal of Developmental Medicine(Electronic Version), 2026, 14(5): 369-375,397.
2026, Vol. 14 
