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Longitudinal motor development of "apparently normal" high-risk infants at 18 months, 3 and 5 years
1Department of Neonatology, Westmead Hospital, Westmead, NSW 2145, Australia. Tracig@westgate.wh.usyd.edu.au
Insights
High-risk infants often experience persistent fine motor deficits and a significant increase in gross motor deficits as they age. The home environment positively influences gross motor development in these children.
Area of Science:
- Pediatrics
- Developmental Neuroscience
- Neonatology
Background:
- Motor development is significantly impacted in premature infants.
- Few studies have longitudinally assessed gross and fine motor skills in this population.
- Premature birth poses risks to neurodevelopmental outcomes.
Purpose of the Study:
- To longitudinally examine motor development in apparently normal, high-risk infants.
- To identify patterns of gross and fine motor skill acquisition.
- To explore factors influencing motor development in preterm infants.
Main Methods:
- Longitudinal observational cohort study of 58 infants born <29 weeks gestation or <1000g.
- Assessed gross and fine motor skills at 18 months, 3, and 5 years using Peabody Developmental Motor Scales.
- Utilized the HOME scale to evaluate the home environment's impact on development.
Main Results:
- Persistent fine motor deficits were observed in 54% (18 months) to 64% (5 years) of children.
- Gross motor deficits increased significantly from 14% at 18 months to 81% at 5 years (p<0.001).
- Higher quality home environments positively correlated with gross motor development.
Conclusions:
- Many high-risk infants exhibit ongoing fine motor skill impairments.
- Gross motor deficits increase with age and more challenging assessments.
- Home environment quality differentially influences gross and fine motor skill development.
Background:
Motor development appears to be more affected by premature birth than other developmental domains, however few studies have specifically investigated the development of gross and fine motor skills in this population.
Aim:
To examine longitudinal motor development in a group of "apparently normal" high-risk infants.
Setting:
Developmental follow-up clinic in a perinatal centre.
Study Design:
Longitudinal observational cohort study.
Subjects:
Fifty-eight infants born less than 29 weeks gestation and/or 1000 g and without disabilities detected at 12 months.
Outcome Measures:
Longitudinal gross and fine motor skills at 18 months, 3 and 5 years using the Peabody Developmental Motor Scales. The HOME scale provided information of the home environment as a stimulus for development.
Results:
A large proportion (54% at 18 months, 47% at 3 years and 64% at 5 years) of children continued to have fine motor deficits from 18 months to 5 years. The proportion of infants with gross motor deficits significantly increased over this period (14%, 33% and 81%, p<0.001), particularly for the 'micropreemies' (born <750 g). In multivariate analyses, gross motor development was positively influenced by the quality of the home environment.
Conclusions:
A large proportion of high-risk infants continued to have fine motor deficits, reflecting an underlying problem with fine motor skills. The proportion of infants with gross motor deficits significantly increased, as test demands became more challenging. In addition, the development of gross and fine motor skills appears to be influenced differently by the home environment.