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Motor-related health care for 5-year-old children born extremely preterm with movement impairments

Raquel Costa1,2, Adrien M Aubert3, Anna-Veera Seppänen3

  • 1EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.

Developmental Medicine and Child Neurology
|March 17, 2022
PubMed

Insights

Many children born extremely preterm experience motor difficulties and cerebral palsy, yet most do not receive necessary motor-related health care (MRHC). Increased access to MRHC is crucial for these vulnerable children.

Area of Science:

  • Pediatrics
  • Developmental Pediatrics
  • Neurology

Background:

  • Extremely preterm (EPT) birth (<28 weeks gestation) is associated with increased risk of developmental challenges.
  • Motor difficulties, including cerebral palsy (CP), are common sequelae in EPT survivors.
  • Timely access to motor-related health care (MRHC) is essential for optimizing outcomes in children with motor impairments.

Purpose of the Study:

  • To determine the prevalence of movement difficulties and CP in 5-year-old children born EPT.
  • To assess the proportion of these children receiving MRHC.
  • To identify factors associated with MRHC receipt among EPT children.

Main Methods:

  • Longitudinal cohort study of 807 children born EPT across 11 European countries.
  • Movement assessment using the Movement Assessment Battery for Children, Second Edition (MABC-2) at 5 years of age.
  • Parent-reported data on child health, diagnoses (including CP), and healthcare utilization (MRHC defined as visits with specialized therapists).

Main Results:

  • 21.1% were at risk of movement difficulties, 24.9% had significant movement difficulties (SMD), and 11.4% had CP.
  • MRHC receipt was high for children with CP (89.1%) but lower for those with SMD (42.8%) and at risk (25.9%).
  • Significant geographical variations in MRHC provision were observed across Europe; children with co-occurring developmental or socioemotional difficulties were more likely to receive MRHC.

Conclusions:

  • A substantial proportion of EPT children experience motor difficulties without CP, and most do not receive adequate MRHC.
  • Efforts are needed to improve access to and provision of MRHC for EPT children with motor impairments.
  • Addressing geographical disparities and considering co-occurring conditions are important for equitable MRHC delivery.
Abstract

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