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Influence of behaviour and risk factors on motor performance in preterm infants at age 2 to 3 years
A J W M Janssen1, M W G Nijhuis-van der Sanden, R P Akkermans
1Department of Paediatric Physiotherapy, Radbound University Nijmegen Medical Centre, Nijmegen, The Netherlands. a.janssen@cukz.umcn.nl
Insights
Preterm infants often experience delayed motor performance and suboptimal behavior during assessments. Key risk factors include neonatal convulsions, lower maternal education, male sex, and chronic lung disease.
Area of Science:
- Pediatrics
- Developmental Psychology
- Neonatology
Background:
- Preterm infants are at increased risk for developmental delays.
- Assessing motor performance and behavior in this population is crucial for early intervention.
Purpose of the Study:
- To investigate the influence of test-taking behavior and identify risk factors for delayed motor performance in preterm infants.
- To analyze the correlation between motor performance and behavior during assessments.
Main Methods:
- Cross-sectional study of 437 preterm infants (gestational age ≤ 32 weeks) at 2-3 years corrected age.
- Utilized the Bayley Scales of Infant Development, 2nd edition (BSID-II) Motor Scale and Behavior Rating Scale (BRS).
- Binary logistic regression analysis was employed to identify risk factors for delayed motor performance.
Main Results:
- 46.5% of preterm infants exhibited delayed motor performance, and 31.4% showed non-optimal behavior.
- Significant correlation found between Motor Scale and BRS scores (r(s)=0.62, p<0.01).
- Risk factors for delayed motor performance included neonatal convulsions, low maternal education, male sex, and chronic lung disease.
Conclusions:
- Preterm infants face a high risk of delayed motor development and suboptimal test-taking behaviors.
- Early identification of risk factors is essential for targeted interventions in preterm populations.
Abstract:
The aim of this cross-sectional study was to determine the influence of test-taking behaviour and risk factors for delayed motor performance in 437 preterm infants (244 males, 193 females; < or = 32 weeks of gestation) at the corrected age of 2 to 3 years (mean 29mo [SD 3.3]). Other mean (SD) sample demographics were: postmenstrual age 29(+5) weeks (1(+5)), range 25(+0)-32(+0); birthweight 1213.7g (331.7), range 468-2350; and days in the neonatal intensive care unit 21.1 (21.3), range 1-165. Children (n=23) with a severe disability were excluded. We assessed motor performance and behaviour during testing with the Motor Scale and the Behaviour Rating Scale (BRS) of the Bayley Scales of Infant Development, 2nd edition (BSID-II). Risk factors were tested against delayed motor performance as the dependent variable in binary logistic regression analysis. Median score on the Motor Scale in terms of the BSID-II Psychomotor Developmental Index (PDI) was 86. 'Delayed' motor performance was observed in 46.5% of the children tested, and behaviour was 'not-optimal' in 31.4%. The Motor Scale and BRS scores were significantly correlated (r(s)=0.62, p<0.01). Risk factors for delayed motor performance were: neonatal convulsions (odds ratio [OR] 4.5; 95% confidence interval [CI] 1.6-12.9), low maternal educational level (OR 3.3; 95% CI 1.7-6.5), male sex (OR 2.8; 95% CI 1.8-4.3), and chronic lung disease (OR 2.1; 95% CI 1.1- 4.1). We conclude that preterm infants are at high risk of delayed motor performance and non-optimal test-taking behaviour.
