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Is late walking a marker of morbidity? Steering Committee, Oxford Region Child Development Project
Insights
Late walking in infants is a significant indicator of potential health issues, particularly for premature babies. This early sign can help identify developmental abnormalities and cerebral palsy in young children.
Area of Science:
- Neonatal care
- Pediatric neurology
- Developmental pediatrics
Background:
- Infants born weighing less than 2000g or requiring special care nursery admission are at higher risk for developmental delays.
- Delayed independent walking by 18 months is a concern requiring further investigation.
Purpose of the Study:
- To investigate the prevalence and outcomes of infants identified as late walkers.
- To determine the association between late walking and diagnosed abnormalities, including cerebral palsy.
Main Methods:
- A cohort of 4275 infants was monitored.
- 410 infants identified as late walkers (not walking independently by 18 months) were followed.
- Outcomes were assessed at age 3 years using a standard questionnaire by health visitors.
Main Results:
- 56% of late walkers (230/410) had an abnormality diagnosed by age 3.
- Cerebral palsy was diagnosed or suspected in 33% of these children (77/230).
- 46% of infants born before 28 weeks' gestation were late walkers, primarily due to impairments.
Conclusions:
- Late walking is a simple yet significant marker of morbidity in high-risk infants.
- Early identification of late walkers can facilitate timely diagnosis of developmental abnormalities and cerebral palsy.
Abstract:
We identified 410 infants who were not walking independently by the age of 18 months from among a geographically defined population of 4275 infants who either were born weighing less than 2000 g or had needed admission to the special care nursery in the neonatal period. The outcome of the late walkers was ascertained at the age of 3 years by health visitors using a standard questionnaire. Of the late walkers, 230 (56%) had an associated abnormality diagnosed before the age of 3 years, and in 77 of these children (33%) this was definite or suspected cerebral palsy. The high prevalence of late walking among infants born before 28 weeks' gestation (46%) was almost entirely accounted for by a high incidence of impairment. Late walking is a simple marker of morbidity in this group of infants.