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Updated: May 10, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Movement outcomes of infants born moderate and late preterm
David Edward Odd1, Raghu Lingam, Alan Emond
1Neonatal Unit, Southmead Hospital, Bristol, UK; Clinical Science at North Bristol, University of Bristol, Bristol, UK. david.odd@bristol.ac.uk
Insights
Children born moderately or late preterm (32-36 weeks gestation) face higher risks for motor coordination issues and cerebral palsy (CP). These risks significantly decrease when considering only healthy, well-born infants, suggesting crucial prenatal and perinatal factors.
Area of Science:
- Developmental Pediatrics
- Neurology
- Public Health
Background:
- Preterm birth is a significant global health concern.
- Understanding the long-term neurodevelopmental outcomes of preterm infants is crucial for early intervention.
- Moderate and late preterm birth (32-36 weeks gestation) represent a substantial proportion of preterm births.
Purpose of the Study:
- To determine if moderate or late preterm birth increases the risk of motor coordination difficulties or cerebral palsy (CP) by age 7.
- To analyze the association between gestational age at birth and neurodevelopmental outcomes in childhood.
- To explore potential confounding factors influencing the relationship between preterm birth and motor deficits.
Main Methods:
- A large prospective cohort study utilizing the Avon Longitudinal Study of Parents and Children (ALSPAC) dataset.
- Primary outcomes included poor motor coordination (defined by test scores) and diagnosed cerebral palsy (CP).
- Gestational age was categorized into moderate/late preterm (32-36 weeks) and term (37-42 weeks); regression models and multiple imputation were employed.
Main Results:
- Children born moderately or late preterm showed significantly worse motor coordination (OR 1.41) and a higher risk of CP (OR 6.38) compared to term-born peers, even after full adjustment.
- However, when the analysis was restricted to infants who were well-grown, born vaginally, and in good condition, these associations were substantially attenuated.
- This suggests that factors beyond simple gestational age, potentially related to antenatal, intrapartum, or neonatal events, play a significant role.
Conclusions:
- Moderate and late preterm infants are at an elevated risk for coordination problems and cerebral palsy.
- The findings highlight the importance of considering the infant's overall health status and birth circumstances, not just gestational age.
- Antenatal, intrapartum, and neonatal factors are likely key contributors to the observed neurodevelopmental disparities in preterm infants.
Aim:
To investigate whether children born between 32 and 36 weeks of gestation have an increased risk of motor coordination difficulties or cerebral palsy (CP) at age 7 years.
Methods:
A cohort study based on the Avon Longitudinal Study of Parents and Children (ALSPAC). The primary outcomes were poor motor coordination, defined as an ALSPAC coordination test score <5th centile or the presence of CP. Exposure groups were defined as moderate or late preterm (32-36 weeks of gestation) or term (37-42 weeks). Regression models were used to investigate the association between gestational age and outcomes. Multiple imputation was used to account for missing covariate data.
Results:
In the fully adjusted model, there was strong evidence that children born at moderate or late preterm had worse coordination (OR 1.41 (1.14-1.74)) and higher risk of CP (OR 6.38 (2.28-17.76)) than term peers. However, restricting the analysis to well-grown infants born vaginally, in good condition, the associations attenuated substantially.
Conclusions:
Moderate or late preterm infants were at increased risk of developing coordination problems and cerebral palsy. After restricting the analysis to 'well' infants the associations of gestation with the coordination measures and CP reduced substantially, suggesting that antenatal, intrapartum and neonatal causal pathways are likely to be involved.
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