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Prognostic factors for walking attainment in very low-birthweight preterm infants
1School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, No. 7 Chung-Shan South Road, Taipei, Taiwan. jeng@ha.mc.ntu.edu.tw
Insights
Very low-birthweight (VLBW) preterm infants achieve walking later than normal term infants. Low gestational age, prolonged ventilation, and severe retinopathy of prematurity are linked to delayed walking in VLBW infants.
Area of Science:
- Developmental Pediatrics
- Neonatology
- Motor Development
Background:
- Preterm birth, especially very low-birthweight (VLBW), is associated with developmental challenges.
- Gross motor development, including walking attainment, is a key milestone affected by prematurity.
- Understanding factors influencing walking attainment in VLBW infants is crucial for early intervention.
Purpose of the Study:
- To compare the age of walking attainment between VLBW preterm infants and normal term infants.
- To identify variables associated with delayed walking attainment specifically in VLBW infants.
- To explore potential pathways linking prematurity complications to motor development delays.
Main Methods:
- Prospective cohort study comparing 96 VLBW infants and 82 term infants.
- Gross motor development monitored at 6, 9, 12, and 18 months corrected age.
- Multivariate proportional hazards regression used to analyze predictors of walking attainment.
Main Results:
- VLBW infants attained walking significantly later (median 14 months) than term infants (median 12 months).
- 11% of VLBW infants remained unable to walk by 18 months corrected age, compared to 0% of term infants.
- Low gestational age, prolonged ventilation/oxygen therapy, and severe retinopathy of prematurity were significant predictors of delayed walking in VLBW infants.
Conclusions:
- VLBW preterm infants are at increased risk for delayed walking attainment.
- Low gestational age appears to be a primary factor, potentially mediated by respiratory distress and retinopathy of prematurity.
- These findings highlight the need for close monitoring of motor development in VLBW infants and timely interventions.
Abstract:
The purpose of this study was to compare the age of walking attainment between very low-birthweight (VLBW) preterm infants and normal term infants, and to determine the variables that affect the walking attainment in VLBW infants. Ninety-six VLBW preterm infants and 82 normal term infants were prospectively followed to determine their age of walking attainment and to monitor gross motor development with sequential clinic visits at 6, 9, 12 and 18 months corrected age. Perinatal and sociodemographic data were collected through review of medical records. The VLBW infants were significantly older at attainment of walking (median 14 months) than the term infants (median 12 months) after correction for prematurity. By the age of 18 months, all term infants had attained walking ability; while 11% of VLBW infants were still unable to walk. Multivariate proportional hazards regression analysis revealed that low gestational age was significantly associated with late attainment of walking in VLBW infants. With the adjustment for gestational age, prolonged ventilation (or oxygen therapy) and severe retinopathy of prematurity were significant predictors of late walking attainment. Our findings indicate that VLBW preterm infants have an increased risk of delayed attainment of walking. Furthermore, the contribution of low gestational age to the delayed walking attainment in VLBW infants may occur via the plausible pathways of neonatal respiratory distress and severe retinopathy of prematurity.