We studied infants exposed to severe hyperbilirubinemia in the neonatal period and assessed their General Movements (GMs) and evaluated their ability to predict future neurodevelopment.

General Movements (GMs), the spontaneous early motor repertoire of an infant, have emerged as an important diagnostic tool for predicating future  risk of Cerebral Palsy (CP) in high risk infants(1). GMA requires only a video recording of the infant in appropriate circumstances and is a quick, non-invasive method of assessment without imposing any significant financial burden and any kind of physical contact.

Neonatal hyperbilirubinemia leading to dyskinetic CP is still a major health issue in developing countries. Proper systematic studies with a reliable follow up for determining outcomes of severe hyperbilirubinemia are still scarce. There is no systematic study of GMs till date on infants exposed to hyperbilirubinemia.

Term and late preterm infants exposed to severe hyperbilirubinemia (Peak Total Serum Bilirubin equal or above 20 mg/dl or Peak TSB above Exchange transfusion levels as per guidelines by American Academy of Pediatrics) in the initial 2 weeks of life were recruited and GMA (General Movement Assessment) were done at appropriate ages by two independent blinded certified GMA reviewers. Neurodevelopmental Outcomes were assessed on basis of neurological examination and DASII (Development Assessment Scale for Indian Infants) at 1 year of age.

Out of 44 infants, 8 had abnormal fidgety (Absent and/or Abnormal) and rest had normal fidgety GMs. All infants with abnormal fidgety GMs had adverse neurodevelopmental outcomes (7 developed CP (Cerebral Palsy) and 1 had developmental delay), and out of rest 36 infants, 33 were normal at 1 year of age, and 3 had isolated mild developmental delay.

GMA was found to have high excellent predictive value for predicting neurodevelopment and occurrence of dyskinetic CP in this specialized population of neonates exposed to severe hyperbilirubinemia.