Perinatal and neonatal predictors of developmental coordination disorder in very low birthweight children

Abstract

Objective To identify perinatal and neonatal risk factors associated with developmental coordination disorder (DCD) in very low birthweight children (VLBW: <1250 g). Design Retrospective design with prospectively collected cohort. Setting Neonatal Follow-Up Program, Vancouver, Canada. Patients 157 VLBW children assessed at 4-5 years who were free of cerebral palsy or major neurological impairment and had full-scale IQ >70. Main outcome measure Movement Assessment Battery for Children (MABC).Results Using ≤15th percentile on the MABC as the cut-off, 42% of our cohort developed DCD. Perinatal variables significantly associated with DCD were male sex, lower gestational age and lower birth weight, but only male sex and low birth weight independently predicted DCD, accounting for 20% of the variance in MABC scores. Compared with children without motor impairment, children with DCD had greater postnatal steroid exposure, longer duration of ventilation, more days on oxygen and significant retinopathy of prematurity, but only postnatal steroid exposure was significant, accounting for an additional 3% of the variance in MABC scores. Boys performed more poorly than girls on all subtests of the MABC. Conclusions Male sex and low birth weight were significant predictors of DCD, suggesting that these infants should be followed for detection of this common, but under-recognised disorder. Future research aimed at identifying neural underpinnings of DCD and possible antecedents to the disorder is warranted.

The motor profile of preterm infants at 11 y of age

“…Different care practices may have different effects especially on the vulnerability of the basal ganglia and cerebellum, which modify the profile/quality of movement in motor performance. Another difference compared to previous literature was that no effect of gender or small for gestational age status on the motor performance was found (4,9,10). This is consistent with our previous results of similar outcomes in small for gestational age infants (20)(21)(22).…”

“…A previous study of perinatal and neonatal predictors for DCD in very low birthweight children has shown that male sex, lower gestational age, lower birthweight, postnatal steroid exposure, longer duration of ventilation, more days of oxygen, retinopathy of prematurity, and hyponatremia were associated with poorer motor outcome. Of these variables, only male sex, low birthweight and postnatal steroid exposure remained significant with the addition of neonatal factors (10).…”

“…The Developmental Coordination Disorder (DCD) is defined as a motor impairment that appears in the absence of any obvious neurological and structural abnormality or intellectual disability that would interfere with activities of daily living or academic performance (9). The prevalence of DCD in school-aged children is 5-6%, the reported prevalence being higher in children born at very low birth weight or very preterm, from 9.5 to 51% (4,7,9,10).…”

Diagnosis and management of developmental coordination disorder

“…6 Boys are 1.7 to 2.8 times more likely than girls to have the disorder. 7,8 • Developmental coordination disorder is a prevalent childhood disability affecting 5%-6% of school-aged children.…”

“…7 A retrospective study involving children 4-5 years of age confirmed the associations with male sex and low birth weight; it also found an association with postnatal exposure to steroids. 8 Children with developmental coordination disorder are at increased risk of being overweight or obese. 9 In a prospective, population-based cohort study in southwestern England, probable developmental coordination disorder was identified in 346 children aged 7-9.…”