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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Perinatal and neonatal predictors of developmental coordination disorder in very low birthweight children
Jill Glennis Zwicker1, Shin Won Yoon, Margot Mackay
1Neonatal Follow-Up Program, British Columbia's Women's Hospital, Room 1R13, 4480 Oak St., Vancouver, BC, Canada V6H 3V4.
Insights
Male sex and low birth weight are key predictors of developmental coordination disorder (DCD) in very low birthweight (VLBW) children. Early identification and follow-up are crucial for these infants.
Area of Science:
- Developmental Pediatrics
- Neonatal Medicine
- Neuroscience
Background:
- Developmental Coordination Disorder (DCD) affects a significant proportion of children.
- Very low birthweight (VLBW) infants are at increased risk for neurodevelopmental challenges.
- Identifying early risk factors for DCD in VLBW populations is critical for timely intervention.
Purpose of the Study:
- To investigate perinatal and neonatal risk factors associated with DCD in very low birthweight (VLBW) children.
- To determine predictors of motor impairment in a cohort of VLBW infants.
Main Methods:
- Retrospective cohort study of 157 VLBW children assessed at 4-5 years.
- Exclusion criteria included cerebral palsy, major neurological impairment, and full-scale IQ <70.
- Movement Assessment Battery for Children (MABC) was used to diagnose DCD (≤15th percentile).
Main Results:
- 42% of the VLBW cohort met criteria for DCD.
- Male sex and low birth weight were significant independent predictors of DCD, explaining 20% of the variance in MABC scores.
- Boys demonstrated poorer performance on all MABC subtests compared to girls.
Conclusions:
- Male sex and low birth weight are significant predictors of DCD in VLBW children.
- These findings underscore the need for targeted follow-up of VLBW infants, particularly males, for early DCD detection.
- Further research into the neural underpinnings and antecedents of DCD is warranted.
Objective:
To identify perinatal and neonatal risk factors associated with developmental coordination disorder (DCD) in very low birthweight children (VLBW: <1250 g).
Design:
Retrospective design with prospectively collected cohort.
Setting:
Neonatal Follow-Up Program, Vancouver, Canada.
Patients:
157 VLBW children assessed at 4-5 years who were free of cerebral palsy or major neurological impairment and had full-scale IQ >70.
Main Outcome Measure:
Movement assessment battery for children (MABC).
Results:
Using ≤15th percentile on the MABC as the cut-off, 42% of our cohort developed DCD. Perinatal variables significantly associated with DCD were male sex, lower gestational age and lower birth weight, but only male sex and low birth weight independently predicted DCD, accounting for 20% of the variance in MABC scores. Compared with children without motor impairment, children with DCD had greater postnatal steroid exposure, longer duration of ventilation, more days on oxygen and significant retinopathy of prematurity, but only postnatal steroid exposure was significant, accounting for an additional 3% of the variance in MABC scores. Boys performed more poorly than girls on all subtests of the MABC.
Conclusions:
Male sex and low birth weight were significant predictors of DCD, suggesting that these infants should be followed for detection of this common, but under-recognised disorder. Future research aimed at identifying neural underpinnings of DCD and possible antecedents to the disorder is warranted.
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