The aetiology of mild motor disability (MMD) is a complex issue and as yet is poorly understood. The aim of this study was to identify the prevalence of perinatal risk factors in a cohort of 10-year-old boys and girls with (n = 362) and without (n = 1193) MMD. Among the males with MMD there was a higher prevalence of postpartum haemorrhage, caesarean section, low birth weight and stressful first year of life. Among the females with MMD, there was a higher prevalence of essential hypertension, anaemia, and threatened pre-term.Multivariable logistic regression revealed gender (male), anaemia, threatened pre-term birth (if female), and hypertension (if female) weakly explained MMD at 10 years. These results underscore the importance of considering gender differences in order to better understand the multiple influences on motor development.Keywords: Developmental Coordination Disorder; Gender differences; Motor disability; Maternal; Perinatal; Risk factors
IntroductionMild motor disability (MMD) is a condition in which impairment in motor coordination cannot be explained by any known physical disorder or other diagnosed condition. The prevalence of this condition ranges from 6% to 22% depending on the terminology and assessment criteria used (for review see Cermak, Gubbay, & Larkin, 2002). The consequences of poor motor development have been well documented (Cantell, Crawford, & Doyle-Baker, 2008;Summers, Larkin, & Dewey, 2008); however, less is understood about the early risk factors for this condition and whether * Corresponding author. Email: bhands@nd.edu.au 2 B. Hands et al.they differ between boys and girls. Brain damage, heredity or genetic disposition, neurological impairment or a suboptimal environment have been implicated (Gubbay, 1975;Larkin & Hoare, 1991), although it is likely that more than one factor may contribute. Of interest to this article is the contribution of an infant's in-utero and early life experiences to their later motor development. A detailed examination of early childhood risk factors of MMD remains a distinctive gap in the literature, although the notion that some maternal and perinatal factors have the potential to contribute to suboptimal motor outcomes is not new.A higher incidence of birth-related factors such as prolonged labour, abnormal delivery, caesarean section, or use of forceps (Gubbay, 1975;Hoare, 1991) or childrelated factors such as toxaemia, jaundice, intrauterine growth restriction (IUGR), preterm or overdue birth dates, or need for ventilation (Davis, Ford, Anderson, & Doyle, 2007;Hoare, 1991;Johnston, Short, & Crawford, 1987;Jongmans, Henderson, de Vries, & Dubowitz, 1993;Michelsson & Lindahl, 1993) have been noted among MMD children. As early as 1947, Gesell and Amatruda reported a higher incidence of birth injuries among children with motor difficulties. More recently, Hadders-Algra (2002) found that combinations of pre-and perinatal stressors, such as preterm birth or intrauterine growth restriction, resulted in differing levels of minor neurological dysfunction...