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Measurements of Motor Function and Other Clinical Outcome Parameters in Ambulant Children with Duchenne Muscular Dystrophy
Published on: January 12, 2019
Health Profile of Preterm Males With Duchenne Muscular Dystrophy
Aida Soim1, Bailey Wallace2,3, Nedra Whitehead4
11094New York State Department of Health, Albany, NY, USA.
Insights
Preterm birth may impact Duchenne muscular dystrophy (DMD) progression, particularly respiratory interventions. While overall disease course is similar, preterm males with DMD may experience earlier pulmonary function decline.
Area of Science:
- Neurology
- Pediatrics
- Genetics
Background:
- Duchenne muscular dystrophy (DMD) is a severe X-linked genetic disorder.
- Preterm birth is a significant factor influencing neonatal health outcomes.
- Limited data exists on the specific health profiles of preterm males with DMD.
Purpose of the Study:
- To characterize the health profile and disease progression in preterm males with Duchenne muscular dystrophy.
- To compare clinical milestones and treatment patterns between preterm and full-term males with DMD.
- To identify potential differences in disease impact related to prematurity.
Main Methods:
- Retrospective cohort study utilizing a population-based surveillance system.
- Analysis of major clinical milestones: ambulation cessation, assisted ventilation, and left ventricular dysfunction.
- Kaplan-Meier survival curves and Cox proportional hazards modeling were employed.
Main Results:
- Preterm males with DMD had an 87% higher adjusted risk for respiratory interventions compared to full-term males.
- Adjusted risks for ambulation cessation and left ventricular dysfunction were modestly elevated but not statistically significant.
- No significant difference was observed in the initiation of corticosteroid therapy between preterm and full-term males with DMD.
Conclusions:
- The overall disease course of Duchenne muscular dystrophy appears similar between preterm and full-term males.
- Pulmonary function may be affected earlier in preterm males with DMD, necessitating closer monitoring.
- Prematurity is associated with an increased risk of respiratory complications in Duchenne muscular dystrophy.
Abstract:
In this retrospective cohort study, we characterize the health profile of preterm males with Duchenne muscular dystrophy. Major clinical milestones (ambulation cessation, assisted ventilation use, and onset of left ventricular dysfunction) and corticosteroids use in males with Duchenne muscular dystrophy identified through a population-based surveillance system were analyzed using Kaplan-Meier survival curves and Cox proportional hazards modeling. The adjusted risk of receiving any respiratory intervention among preterm males with Duchenne muscular dystrophy was 87% higher than among the corresponding full-term males with Duchenne muscular dystrophy. The adjusted risks for ambulation cessation and left ventricular dysfunction were modestly elevated among preterm compared to full-term males, but the 95% confidence intervals contained the null. No difference in the start of corticosteroid use between preterm and full-term Duchenne muscular dystrophy males was observed. Overall, the disease course seems to be similar between preterm and full-term males with Duchenne muscular dystrophy; however, pulmonary function seems to be affected earlier among preterm males with Duchenne muscular dystrophy.
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