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Motor development in very preterm and very low-birth-weight children from birth to adolescence: a meta-analysis
Jorrit F de Kieviet1, Jan P Piek, Cornelieke S Aarnoudse-Moens
1Department of Clinical Neuropsychology, VU University Amsterdam, van der Boechorststraat 1, 1081 BT Amsterdam, the Netherlands. jf.de.kieviet@psy.vu.nl
Insights
Very preterm birth and low birth weight are linked to lasting motor skill deficits in children. These developmental challenges persist throughout childhood, impacting motor development significantly.
Area of Science:
- Pediatrics
- Developmental Psychology
- Neuroscience
Background:
- Infants born very preterm (<= 32 weeks gestation) or with very low birth weight (VLBW, <= 1500g) face heightened risks for adverse developmental outcomes.
- While evidence suggests a substantial impact of preterm birth and VLBW on motor development, existing findings remain inconsistent.
Purpose of the Study:
- To systematically investigate the association between very preterm birth, VLBW, and motor development in children.
- To synthesize findings from studies utilizing standardized motor assessments.
Main Methods:
- A comprehensive literature search was conducted across EMBASE, PubMed, and Web of Knowledge for English-language articles published between January 1992 and August 2009.
- Included studies reported motor scores for very preterm and VLBW children (without congenital anomalies) using the Bayley Scales of Infant Development II (BSID-II), Movement Assessment Battery for Children (MABC), or Bruininks-Oseretsky Test of Motor Proficiency (BOTMP).
- Data from 41 articles, encompassing 9653 children, were analyzed.
Main Results:
- Very preterm and VLBW children consistently scored lower on all three motor tests compared to term-born peers.
- Significant deficits were observed across all measures: BSID-II (d = -0.88), MABC (d = -0.65), and BOTMP (d = -0.57).
- While some catch-up was noted on the BSID-II in early years, deficits on the MABC tended to increase with age through adolescence.
Conclusions:
- Preterm birth and VLBW are significantly associated with motor impairments.
- These motor deficits demonstrate persistence throughout childhood, underscoring the long-term impact of early-life factors.
- The findings highlight the need for continued monitoring and support for motor development in this vulnerable population.
Context:
Infants who are very preterm (born < or = 32 weeks of gestation) and very low birth weight (VLBW) (weighing < or = 1500 g) are at risk for poor developmental outcomes. There is increasing evidence that very preterm birth and VLBW have a considerable effect on motor development, although findings are inconsistent.
Objective:
To investigate the relationship between very preterm birth and VLBW and motor development.
Data Sources:
The computerized databases EMBASE, PubMed, and Web of Knowledge were used to search for English-language peer-reviewed articles published between January 1992 and August 2009.
Study Selection:
Studies were included if they reported motor scores of very preterm and VLBW children without congenital anomalies using 1 of 3 established and widely used motor tests: the Bayley Scales of Infant Development II (BSID-II), the Movement Assessment Battery for Children (MABC), and the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP). Forty-one articles were identified, encompassing 9653 children.
Results:
In comparison with term-born peers, very preterm and VLBW children obtained significantly lower scores on all 3 motor tests: BSID-II: d = -0.88 (95% confidence interval [CI], -0.96 to -0.80; P < .001), MABC: d = -0.65 (95% CI, -0.70 to -0.60; P < .001), and BOTMP: d = -0.57 (95% CI, -0.68 to -0.46; P < .001). Whereas motor outcomes on the BSID-II show a catch-up effect in the first years of development (r = 0.50, P = .01), the results on the MABC demonstrate a nonsignificantly greater deficit with increasing age during elementary school and early adolescence (r = -0.59, P = .07).
Conclusion:
Being born preterm or VLBW is associated with significant motor impairment persisting throughout childhood.
