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Risk factors for cerebral palsy and movement difficulties in 5-year-old children born extremely preterm

Adrien M Aubert1, Raquel Costa2,3, Samantha Johnson4

  • 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. adrien.aubert@inserm.fr.

Pediatric Research
|January 24, 2023
PubMed

Insights

Extremely preterm birth increases risks for cerebral palsy (CP) and movement difficulties (MD). While some factors like young maternal age affect both, CP is linked to clinical issues, and non-CP MD to sociodemographic factors.

Area of Science:

  • Neonatalogy
  • Developmental Pediatrics
  • Public Health

Background:

  • Motor impairment is prevalent in extremely preterm (EPT) infants (<28 weeks' gestational age).
  • Cerebral palsy (CP) affects ~10%, and non-CP movement difficulties (MD) affect up to 50% of EPT survivors.
  • Identifying risk factors for CP and non-CP MD is crucial for early intervention.

Purpose of the Study:

  • To investigate sociodemographic, perinatal, and neonatal risk factors for CP and non-CP MD in EPT children.
  • To differentiate risk profiles between CP and non-CP MD.

Main Methods:

  • Analysis of a European population-based cohort of EPT children born in 2011-2012.
  • Multinomial logistic regression used to assess risk factors for CP and non-CP MD versus no MD in 5-year-olds.
  • Movement Assessment Battery for Children - 2nd edition used for MD classification.

Main Results:

  • Young maternal age, male sex, and bronchopulmonary dysplasia were associated with both CP and non-CP MD.
  • CP was strongly linked to severe brain lesions, neonatal morbidities, congenital anomalies, and low Apgar scores.
  • Non-CP MD showed associations with primiparity, maternal education, small for gestational age, and severe brain lesions (lower magnitude).

Conclusions:

  • CP and non-CP MD exhibit distinct risk factor profiles.
  • Non-CP MD is more associated with sociodemographic factors, while CP is more linked to clinical factors.
  • Understanding these differences aids etiological research and identifies children for targeted follow-up and intervention.
Abstract

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