Strength, Motor Skills, and Physical Activity in Preschool-Aged Children Born Either at Less Than 30 Weeks of Gestation or at Term

Abstract

Objective Children born < 30 weeks’ gestation have more motor impairment than do children born at term (37–42 weeks’ gestation), but reported outcomes have largely focused on cerebral palsy (CP) and Developmental Coordination Disorder (DCD). The aim of this study was to compare muscle strength, motor skills and physical activity of preschool-aged children born < 30 weeks with those born at term. Methods In this cohort study, 123 children born < 30 weeks and 128 born at term were assessed. Children were ≥ 4 years, 0 months and < 6 years, 0 months’ corrected age at the time of the assessment. Outcomes included: grip strength (kg), Movement Assessment Battery for Children 2nd edition (MABC-2), Little Developmental Coordination Disorder Questionnaire (L-DCDQ), accelerometer-measured physical activity (PA), and a parent-completed PA diary. Linear regression and mixed effects models were used to examine differences between children born < 30 weeks and those born at term. Results Children born < 30 weeks had poorer grip strength (preferred hand; mean difference [95% confidence interval] -0.60 kg [−1.04, −0.15], p = 0.008) and poorer motor competence (MABC-2 standard score mean difference − 2.17 [−3.07, −1.27], p < 0.001; L-DCDQ total score mean difference − 5.5 [−9.2, −2.8], p < 0.001) than term-born children. Children born < 30 weeks also completed fewer minutes of accelerometer-measured PA (mean difference − 41 minutes, [−62, −20], p < 0.001), more minutes of accelerometer-measured stationary behavior (mean difference 33 minutes, [12, 54], p = 0.002), and more minutes of parent-reported screen time (mean difference 21 minutes, [10, 32], p < 0.001) per day. Conclusions Preschool-aged children born < 30 weeks had poorer muscle strength, motor skills and physical activity levels than term-born children. These findings suggest that preschool-aged children born < 30 weeks may benefit from enhanced surveillance and PA promotion to improve life-long health outcomes. Impact In our study, children born < 30 weeks had reduced muscle strength, poorer motor skills, participated in less physical activity (PA), and had more stationary and screen behaviour than term-born children. These findings emphasize that awareness of multidomain motor deficits in children born < 30 weeks’ gestation is needed in clinical practice. Given the associations between higher PA and health benefits, and recognition that PA levels can track from early childhood into adulthood, our study highlights the need for assessment and promotion of PA in preschool-aged children born < 30 weeks’ gestation. Lay Summary Children born < 30 weeks had reduced muscle strength, poorer motor skills, participated in less physical activity (PA), and had more stationary and screen behavior than term-born children. Awareness of multidomain motor deficits in children born at < 30 weeks’ gestation is needed in clinical practice. Given the associations between higher PA and health benefits, and in recognition that PA levels can track from early childhood into adulthood, this study highlights the need for assessment and promotion of PA in preschool-aged children born at < 30 weeks’ gestation.

Prevalence of meeting 24-Hour Movement Guidelines from pre-school to adolescence: A systematic review and meta-analysis including 387,437 participants and 23 countries

“…A total of 387,437 participants (49% of boys and 51% of girls) aged 3–18 years were included in this systematic review and meta-analysis, of which 11,768 were preschoolers (3–5 years; 3%), 76,928 (6–12 years; 20%) were children, and 298,741 (13–18 years; 77%) were adolescents. Twenty-six studies were conducted with preschoolers only, 8 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 13 studies with children only, 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 17 studies with adolescents only, 11 , 12 , 60 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 and 7 studies with both children and adolescents. 9 , 10 , 76 , 77 ...…”

“…Regarding the measurement of the 3 components of the 24-Hour Movement Guidelines, physical activity was obtained by device-based measures in 37 studies, 8 , 9 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 46 , 47 , 49 , 51 , 52 , 53 , 54 , 55 , 59 , 64 , 65 , 73 , 76 , 78 , 81 self-reported measures in 22 studies, 10 , 11 , 12 , 50 , 57 , 58 , 60 , 61 , 62 , 63 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 74 , 75 , 77 , 79 , 80 and parent-reported measures in 4 studies. 32 , 45 , ...…”

“… 32 , 45 , 48 , 56 Screen time was self-reported in 35 studies, 9 , 10 , 11 , 12 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 49 , 50 , 51 , 52 , 53 , 54 and were parent-reported in 28 studies. 8 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 52 , ...…”

Adherence to Canadian 24-Hour Movement Guidelines among infants and associations with development: a longitudinal study

“…Though previous research has shown that physical activity and sedentary behaviour in early childhood can track over time [ 37 , 38 ], minimal evidence exists on whether 24-Hour Movement Guideline adherence tracks over time. In the meta-analysis previously discussed, only eight out of 63 included studies were longitudinal, including three in the preschool-aged group [ 10 – 12 ]. Of these eight studies, only two examined the tracking of guideline adherence [ 22 , 39 ].…”

Revealing the impact of lifestyle stressors on the risk of adverse pregnancy outcomes with multitask machine learning

“…The adverse pregnancy outcomes (APOs) that we will focus on in this work -including early gestational age (GA) at delivery (a continuous surrogate for preterm birth), gestational diabetes, severe preeclampsia (severe pree), or preeclampsia superimposed on hypertension (superimposed pree) -are associated with severe short-and long-term consequences for both the mother and infant (1)(2)(3)(4), underscoring the importance of management and prevention (5)(6)(7)(8)(9). Currently, however, highly efficacious therapeutic options to prevent APOs are lacking, highlighting the critical clinical need to identify actionable risk targets and prevent their development (10).…”