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Stability of longitudinal motor development in very low birthweight infants from 5 months to 5.5 years
C Erikson1, C Allert, E Brogren Carlberg
1Department of Child Neurology, Astrid Lindgren Children's Hospital, Karolinska Hospital, Stockholm, Sweden. christina.eriksson@ks.se
Insights
Motor development in very low birthweight (VLBW) infants shows mixed stability, influenced by factors like birthweight and brain injury. Most VLBW children perform normally by age 5.5, but lag behind peers.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Motor development research
Background:
- Assessing motor performance in very low birthweight (VLBW) infants is crucial for early intervention.
- Longitudinal tracking of motor development in VLBW infants is essential to understand developmental trajectories.
- Understanding the impact of prematurity-related complications on long-term motor outcomes is a key area of research.
Purpose of the Study:
- To prospectively evaluate the longitudinal stability of motor development in VLBW infants.
- To investigate the association between motor development and factors such as birthweight, gestational age, intraventricular haemorrhage (IVH), periventricular leucomalacia (PVL), and retinopathy of prematurity (ROP).
- To compare the motor behavior of VLBW children with term-born controls at 5.5 years of age.
Main Methods:
- Prospective assessment of motor performance in 165 VLBW infants at multiple time points (5, 10, 18 months, and 5.5 years).
- Ranking of motor development results into four levels to evaluate stability.
- Comparison of VLBW children and controls using Movement ABC percentiles at 5.5 years.
Main Results:
- Fifty-three percent of VLBW infants demonstrated stable motor development, significantly influenced by PVL and birthweight.
- Forty-seven percent showed unstable motor development, not associated with specific risk factors.
- While most VLBW children performed within the normal range at 5.5 years, their performance was inferior to term-born controls. IVH and severe ROP were linked to poorer motor outcomes.
Conclusions:
- Individualized follow-up programs are recommended for VLBW infants with poor early motor performance or severe IVH/PVL and ROP.
- Regular ongoing monitoring may suffice for VLBW infants with normal early motor development and ultrasound findings.
- Early motor assessment and consideration of specific risk factors are vital for guiding follow-up strategies in VLBW populations.
Aim:
The motor performance of 165 very low birthweight (VLBW) infants was assessed prospectively at 5, 10, 18 mo and 5.5 y. The aim of the study was to evaluate longitudinal stability of motor development and its association with birthweight (BW), gestational age at birth, intraventricular haemorrhage (IVH), periventricular leucomalacia (PVL) and retinopathy of prematurity (ROP). Furthermore, at 5.5 y the motor behaviour of the VLBW population was compared with that of 124 children born at term.
Methods:
The results of each examination were ranked into four levels and the stability of motor development was evaluated on the basis of this ranking. At 5.5 y, VLBW children and controls were compared according to percentiles in the Movement ABC.
Results:
Fifty-three percent of the VLBW infants displayed a stable motor development. Only PVL and BW contributed significantly to the variability in their motor performance. Forty-seven percent of the infants exhibited an unstable motor development with no association to risk factors. In the entire group only IVH and severe ROP were related to poor motor performance. The majority of the VLBW children performed within the normal range at 5.5 y but their performances were inferior to those of control children.
Conclusion:
VLBW infants with poor early motor performance and/or severe IVH/PVL and ROP should be recruited into individualized follow-up programmes, whereas regular ongoing monitoring by follow-up may be sufficient for those with normal early motor performance and normal ultrasound findings.
