Motor skills in extremely low birthweight children at the age of 6 years
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N Marlow1, B L Roberts, R W Cooke
1Department of Child Health, Liverpool Maternity Hospital.
Insights
Extremely low birthweight children, even without cerebral palsy, show significant motor difficulties and subtle neuromotor impairments at age six. Perinatal factors significantly impact motor skill development, affecting school readiness.
Area of Science:
- Pediatrics
- Neurodevelopmental Disorders
- Child Psychology
Background:
- Extremely low birthweight (ELBW) infants often face developmental challenges.
- Subtle neuromotor impairments can impact academic and social functioning in school-aged children.
- Cerebral palsy is a known risk, but less is understood about motor skills in ELBW children without it.
Purpose of the Study:
- To investigate motor skills and associated factors in 6-year-old children with ELBW but without cerebral palsy.
- To compare motor impairment in ELBW children to matched controls.
- To identify perinatal factors influencing motor development in this population.
Main Methods:
- A controlled study matched 53 ELBW children (birthweight < 1251 g) with controls by age, sex, and school.
- Children were assessed for motor impairment, neurological signs, intelligence quotient (IQ), and behavioral traits.
- Neonatal cerebral ultrasound and Apgar scores were analyzed for correlations with motor outcomes.
Main Results:
- ELBW children exhibited significantly higher motor difficulties and more minor neurological signs than controls.
- Lower IQ and more adverse behavioral traits were noted in the ELBW group, independent of IQ differences.
- Apgar scores < 7 at 5 minutes correlated with higher motor impairment scores. Perinatal factors explained 32% of motor impairment variance.
Conclusions:
- ELBW children without cerebral palsy experience significant subtle neuromotor impairments affecting motor skills.
- Perinatal factors, including Apgar scores, neonatal septicaemia, and abnormal movements, are crucial in motor skill development.
- These subtle impairments have implications for schooling and warrant further investigation and support.
Abstract:
Fifty three children aged 6 years old who had weighed less than 1251 g at birth without cerebral palsy and receiving mainstream education, were entered into a controlled study of motor skills. The index and control children were matched by age, sex, and school. The index group were considered by their teachers to have similar academic performances to their index group were considered by their teachers to have similar academic performances to their controls, although two index cases were receiving remedial teaching. On the test of motor impairment extremely low birthweight children had significantly more motor difficulties than controls. In addition, the index group had more minor neurological signs, lower intelligence quotients, and more adverse behavioural traits. The higher motor impairment scores among index children were independent of differences in intelligence quotient between the two groups. There was no association between impairment score and the presence or degree of periventricular haemorrhage or periventricular leucomalacia on neonatal cerebral ultrasound. Children with Apgar scores at five minutes of less than 7 had significantly higher impairment scores compared with those whose scores were 7 or more. Three perinatal factors (Apgar score at five minutes, neonatal septicaemia, and abnormal movements) explained 32% of the variance in impairment score at the age of 6 years. In children who do not have cerebral palsy perinatal factors may still be important in the development of motor skills. The presence of subtle neuromotor impairments at 6 years of age has implications for schooling that need further evaluation.