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Motor Development Interventions for Preterm Infants: A Systematic Review and Meta-analysis
Anita J Hughes1, Sarah A Redsell2, Cris Glazebrook3
1School of Health Sciences, University of Nottingham, Nottingham, United Kingdom; and anita.hughes@nottingham.ac.uk.
Insights
Interventions improve motor skills in preterm infants up to 24 months corrected age. Motor-specific activities show the most significant benefits at 3 months.
Area of Science:
- Neonatal development
- Pediatric neurology
- Rehabilitation medicine
Background:
- Preterm infants face heightened risks of neurodevelopmental delays.
- Existing research suggests positive intervention effects on motor outcomes, but optimal strategies remain unclear.
Purpose of the Study:
- To identify interventions that enhance motor development in preterm infants.
- To determine the short-term and long-term effectiveness of various motor interventions.
Main Methods:
- A systematic review and meta-analysis of 36 trials (3484 infants) published from 1980 to 2015.
- Searched 17 electronic databases and gray literature.
- Analyzed motor skills assessment scores using standardized mean differences.
Main Results:
- Positive intervention effects on motor skills were observed up to 24 months corrected age.
- Motor-specific interventions demonstrated a large, significant effect at 3 months (mean 2.00).
- Heterogeneity was significant, necessitating a random-effects model.
Conclusions:
- Interventions positively impact preterm infants' motor skills up to 24 months corrected age.
- Early, motor-specific interventions appear most effective.
- Further research is needed to address data limitations beyond 24 months.
Contexts:
Preterm infants are at an increased risk of neurodevelopmental delay. Some studies report positive intervention effects on motor outcomes, but it is currently unclear which motor activities are most effective in the short and longer term.
Objective:
The aim of the study was to identify interventions that improve the motor development of preterm infants.
Data Sources:
An a priori protocol was agreed upon. Seventeen electronic databases from 1980 to April 2015 and gray literature sources were searched.
Study Selection:
Three reviewers screened the articles.
Data Extraction:
The outcome of interest was motor skills assessment scores. All data collection and risk of bias assessments were agreed upon by the 3 reviewers.
Results:
Forty-two publications, which reported results from 36 trials (25 randomized controlled trials and 11 nonrandomized studies) with a total of 3484 infants, met the inclusion criteria. A meta-analysis was conducted by using standardized mean differences on 21 studies, with positive effects found at 3 months (mean 1.37; confidence interval 0.48-2.27), 6 months (0.34; 0.11-0.57), 12 months (0.73; 0.20-1.26), and 24 months (0.28; 0.07-0.49). At 3 months, there was a large and significant effect size for motor-specific interventions (2.00; 0.28-3.72) but not generic interventions (0.33; -0.03 to -0.69). Studies were not excluded on the basis of quality; therefore, heterogeneity was significant and the random-effects model was used.
Limitations:
Incomplete or inconsistent reporting of outcome measures limited the data available for meta-analysis beyond 24 months.
Conclusions:
A positive intervention effect on motor skills appears to be present up to 24 months' corrected age. There is some evidence at 3 months that interventions with specific motor components are most effective.
