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Movement Difficulties at Age Five Among Extremely Preterm Infants.

Adrien M Aubert¹, Raquel Costa², Ulrika Ådén³

¹Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, F-75004 Paris, France.

|May 26, 2022

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Children born extremely preterm (EPT) have high rates of movement difficulties, affecting over half of those without cerebral palsy. Risk factors include lower gestational age, brain lesions, and maternal characteristics, highlighting the need for targeted early interventions.

Area of Science:

Pediatric Neurology
Developmental Pediatrics
Public Health

Background:

Children born extremely preterm (EPT), before 28 weeks' gestational age, exhibit increased risks for motor impairments compared to term-born infants.
Existing research shows inconsistent prevalence estimates and prognostic factors for movement difficulties in EPT populations, complicating early intervention strategies.

Purpose of the Study:

To determine the prevalence of movement difficulties in children born EPT without cerebral palsy.
To identify perinatal, neonatal, and sociodemographic risk factors associated with these movement difficulties.

Main Methods:

A population-based cohort of 772 children born EPT in 11 European countries were assessed at 5 years using the Movement Assessment Battery for Children-Second Edition.
Multinomial logistic regression analyzed associations between movement difficulties and collected sociodemographic, perinatal, and neonatal data.

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Main Results:

Over half of EPT children (23.2% at risk, 31.7% significant difficulties) exhibited movement difficulties.
Significant difficulties were linked to lower gestational age, brain lesions, and postnatal corticosteroids. Male sex and bronchopulmonary dysplasia were associated with increased risk.
Maternal factors (younger, primiparous, less educated, non-European born) also correlated with higher prevalence of significant movement difficulties.

Conclusions:

A high prevalence of movement difficulties persists in EPT children even without cerebral palsy.
Identified risk factors, including perinatal, neonatal, and sociodemographic variables, underscore the need for tailored early interventions and highlight country-specific variations.