At school age, a majority of preterm children with late-onset sepsis had motor problems. Their IQ was considerably lower than matched controls, and memory and attention were specifically impaired. Outcome at school age of preterm children with late-onset sepsis was worse than previously thought.

ASQAges and Stage Questionnaire BOTMP Bruininks-Oseretsky Test of Motor Proficiency MABC Movement Assessment Battery for ChildrenFine motor skills are related to functioning in daily life and at school. We reviewed the status of knowledge, in preterm children, on the development of fine motor skills, the relation with gross motor skills, and risk factors for impaired fine motor skills. We searched the past 15 years in PubMed, using ['motor skills' or 'fine motor function' and 'preterm infant'] as the search string. Impaired gross and fine motor skills are among the most frequently occurring problems encountered by preterm children who do not develop cerebral palsy. The prevalence is around 40% for mild to moderate impairment and 20% for moderate impairment. Fine motor skill scores on the Movement Assessment Battery for Children are about 0.62 of a standard deviation lower compared with term children. Risk factors for fine motor impairments include moderately preterm birth (odds ratio [OR] 2.0) and, among very preterm children (<32wk gestation), intra-uterine growth restriction (ORs 2-3), inflammatory conditions (late-onset sepsis and necrotizing enterocolitis, ORs 3-5), and dexamethasone therapy for bronchopulmonary dysplasia (OR 2.7).A better understanding of factors that play a role in the development of and recovery from brain injury could guide future intervention attempts aimed at improving fine motor skills of preterm children.Survival rates of preterm infants have improved during recent decades, and this tendency is continuing. During the same period, the prevalence of major impairments has remained relatively constant or even decreased, 1 but the prevalence of milder dysfunctions is high, 2,3 with a tendency to increase. 4,5 This mainly appears to be the result of the increased survival of very preterm infants (gestational age <32wk), although more sensitive testing may also play a role. 5 Cognitive, behavioural, and mild motor problems without major motor deficits are by now the most dominant neurodevelopmental sequelae in children born preterm, with prevalences reported up to 50 to 70%.5 These 'high prevalence, low severity' impairments often do not occur in isolation and may considerably hamper the children's functional abilities in daily life. 6,7 Among the most frequently occurring problems encountered by preterm children who do not develop cerebral palsy (CP), are impaired gross and fine motor skills.2,4 Because particularly fine motor skills are related to adequate functioning in daily life and at school, our aim was to review the current status of knowledge, in preterm children, on the development of fine motor skills, the relation with gross motor skills, and risk factors for impaired fine motor skills. To this end, we searched PubMed for relevant articles.Impairments in fine motor skills may hamper various aspects of daily functioning such as getting dressed, lacing shoes, eating, and writing. In preterm children without CP, it has been shown that poor fine motor skills affect the learning of w...

ABSTRACT:We aimed to determine motor, cognitive, and behavioral outcome at school age of children who had either necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP). This case-control study included infants with NEC Bell's stage IIA onward, infants with SIP, and matched controls (1996 -2002). At school age, we assessed motor skills, intelligence, visual perception, visuomotor integration, verbal memory, attention, behavior, and executive functions. Of 93 infants with NEC or SIP, 28 (30%) died. We included 52 of 65 survivors for follow-up. At mean age of 9 y, we found that 68% of the children had borderline or abnormal scores on the Movement Assessment Battery for Children (versus 45% of controls). Their mean total intelligence quotient (IQ) was 86 Ϯ 14 compared with 97 Ϯ 9 in the controls. In addition, attention and visual perception were affected (p Ͻ 0.01 and p ϭ 0.02). In comparison to controls, surgically treated children were at highest risk for adverse outcome. In conclusion, at school age, the motor functions and intelligence of many children with NEC or SIP were borderline or abnormal and, specifically, attention and visual perception were impaired. Children with NEC or SIP form a specific risk group for functional impairments at school age even though the majority does not have overt brain pathology. (Pediatr Res 70: 619-625, 2011)