Motor Impairment Trends in Extremely Preterm Children: 1991–2005

Spittle, Alicia J; Cameron, Kate L; Doyle, Lex W.; Cheong, Jeanie L.Y.

doi:10.1542/peds.2017-3410

Cited by 95 publications

(85 citation statements)

References 31 publications

(34 reference statements)

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“…Over the last three decades, changes in reproductive medicine and improvements in neonatal practices and care have led to increased survival rates of smaller infants. However, despite these changes, recent findings indicate that the prevalence of neurodevelopmental sequelae, including motor impairments, has not improved . Thus, although our results should be cautiously interpreted, they provide a baseline for newer cohorts to investigate whether findings differ for children born after our cohorts.…”

Section: Discussionsupporting

confidence: 92%

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Predictors of early motor trajectories from birth to 5 years in neonatal at‐risk and control children

et al. 2019

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Aim To describe motor development in preschool children, to identify perinatal, neonatal and social environmental risk factors of poor motor development, and to replicate results in a second cohort. Methods Two prospective samples in Germany (Bavarian Longitudinal Study, BLS) and Finland (Arvo Ylppö Longitudinal Study, AYLS) assessed 4741 and 1423 children from birth to 56 months, respectively. Motor functioning was evaluated at birth, and 5, 20 and 56 months. Perinatal, neonatal and social environmental information was collected at birth and 5 months. Results Two distinct motor trajectories were identified: low (BLS: n = 4486 (94.6%), AYLS: n = 1391 (97.8%)) and high (BLS: n = 255 (5.4%), AYLS: n = 32 (2.2%)) degree of motor difficulties. High degree of motor difficulties was predicted by neonatal complications, abnormal neonatal neurological status, duration of hospitalisation and poor parent‐infant relationships. Although neonatal complications and poor parent‐infant relationships did not significantly predict high degree of motor difficulties in the AYLS, the trends identified were similar to those obtained from the BLS. Conclusion Early identification of children at‐risk of motor difficulties across infancy and toddlerhood may help referring those children to interventions earlier. Modifiable risk factors, such as parent‐infant relationships, may be addressed by intervention strategies to prevent children from developing motor difficulties.

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Section: Discussionsupporting

confidence: 92%

“…However, despite these changes, recent findings indicate that the prevalence of neurodevelopmental sequelae, including motor impairments, has not improved. 37,38 Thus, although our results should be cautiously interpreted, they provide a baseline for newer cohorts to investigate whether findings differ for children born after our cohorts.…”

Section: Discussionmentioning

confidence: 89%

Predictors of early motor trajectories from birth to 5 years in neonatal at‐risk and control children

et al. 2019

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“…The incidence of cerebral palsy (CP) has decreased among children born very preterm. [1][2][3][4][5][6] However, the rate of non-CP motor impairments such as developmental coordination disorder (DCD) has not decreased, 7 and children born preterm are still at increased risk for cognitive impairment compared with term peers. [8][9][10][11] DCD is defined as motor problems interfering with academic achievement or activities of daily living which cannot be explained by medical, neurological or cognitive impairment.…”

Section: Introductionmentioning

confidence: 99%

Preterm children’s developmental coordination disorder, cognition and quality of life: a prospective cohort study

Uusitalo

Haataja

Nyman

et al. 2020

bmjpo

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ObjectiveTo evaluate the rate of developmental coordination disorder (DCD) and its correlation to cognition and self-experienced health-related quality of life (HRQoL) in children born very preterm.DesignProspective follow-up study.SettingRegional population of children born very preterm in Turku University Hospital, Finland, in 2001–2006.PatientsA total of 170 children born very preterm were followed up until 11 years of age.Main outcome measuresMotor and cognitive outcomes were evaluated using the Movement Assessment Battery for Children - Second Edition (Movement ABC-2) and the Wechsler Intelligence Scale for Children - Fourth Edition, respectively, and HRQoL using the 17-Dimensional Illustrated Questionnaire (17D). The Touwen neurological examination was performed to exclude other neurological conditions affecting the motor outcome.ResultsEighteen children born very preterm (17 boys) (11.3%) had DCD, defined as Movement ABC-2 total test score ≤5th percentile. A positive correlation between motor and cognitive outcome (r=0.22, p=0.006) was found. Children born very preterm with DCD had lower cognitive scores than those without DCD (Full-Scale IQ mean 76.8 vs 91.6, p=0.001). Moreover, children born very preterm with DCD reported lower HRQoL than children born very preterm without motor impairment (17D mean 0.93 vs 0.96, p=0.03). However, HRQoL was higher in this group of children born very preterm compared with population-based normative test results (p<0.001).ConclusionsDCD was still common at 11 years of age in children born very preterm in 2000s. DCD associated with adverse cognitive development and lower self-experienced HRQoL. However, this group of children born very preterm reported better HRQoL in comparison with Finnish norms.

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“…The EPICURE cohort study from England reported that rates of CP and severe disabilities among surviving children were unchanged between 1995 and 2006 [21]. The US National Institute of Child Health and Human Development Neonatal Research Network reported a decrease in the prevalence of severe CP among extremely preterm infants in the period 2011–2014 [22], and a recent population-based cohort study from Australia documented an increase in non-CP motor impairment among extremely preterm infants from 1991–2005, while rates of CP remained relatively constant [23]. …”

Section: Discussionmentioning

confidence: 99%

Type of Re-Hospitalization and Association with Neonatal Morbidities in Infants of Very Low Birth Weight

et al. 2019

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Background: Preterm infants are at high risk for long-term morbidities and an increased rate of re-hospitalization. Objective: The aim of this study was to evaluate the type of re-hospitalization of very low birth weight (VLBW) infants, from infancy through adolescence, and to assess the association of neonatal morbidities with specific types of re-hospitalization. Study Design: The study cohort comprised 6,385 VLBW infants who were registered with the Maccabi Healthcare Services (MHS) from their birth hospitalization. Data were collected for up to 18 years (median 10.7 years) following neonatal intensive care unit discharge. Hospitalization types were determined from the MHS coding. Neonatal morbidities included necrotizing enterocolitis (NEC), grades 3–4 intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), bronchopulmonary dysplasia (BPD), and retinopathy of prematurity (ROP). Adjusted hazard ratios (aHR) and 95% confidence intervals (CI) were calculated using the Cox proportional hazards model. Results: Overall, 3,956 infants were re-hospitalized at least once and a total of 11,595 hospitalization types were identified. NEC, IVH, PVL, and BPD were associated with significantly higher aHRs for general pediatric (aHR 1.28–1.55), general surgical (aHR 1.18–1.46), and pediatric intensive care unit (aHR 1.57–2.04) hospitalizations. IVH and PVL were associated with significantly higher aHRs for orthopedic (aHR 2.12 and 4.88, respectively) and ophthalmology (1.76 and 4.02, respectively) hospitalizations. IVH was associated with a 14.2-fold higher aHR for neurosurgical admissions, and ROP with a 1.62-fold higher aHR for ophthalmology hospitalizations. Conclusion: Among VLBW infants, specific patterns of re-hospitalization types associated with major neonatal morbidities were identified as particularly high risks for orthopedic and ophthalmology hospitalizations in infants with IVH and PVL, and for intensive care admissions in infants with NEC and BPD.

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Motor Impairment Trends in Extremely Preterm Children: 1991–2005

Abstract: The rate of motor impairment in EP and/or ELBW children assessed at 8 years of age increased between eras, an increase caused by non-CP motor impairment.

Cited by 95 publications

References 31 publications

Predictors of early motor trajectories from birth to 5 years in neonatal at‐risk and control children

Predictors of early motor trajectories from birth to 5 years in neonatal at‐risk and control children

Preterm children’s developmental coordination disorder, cognition and quality of life: a prospective cohort study

Type of Re-Hospitalization and Association with Neonatal Morbidities in Infants of Very Low Birth Weight

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