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Early neurological and motor function in infants born moderate to late preterm or small for gestational age at term:
Henriette Paulsen1,2, Ulf Wike Ljungblad3, Kirsti Riiser4
1Department of Physiotherapy and Rehabilitation, Vestfold Hospital Trust, Post box 1068, Tønsberg, NO-3103, Norway. hepaul@siv.no.
Insights
Moderate preterm infants show subtle neurological differences and poorer gross motor skills at two years compared to full-term infants. These findings highlight the long-term risks associated with moderate prematurity.
Area of Science:
- Neonatal development
- Pediatric neurology
- Developmental pediatrics
Background:
- Inconsistent findings exist on neurological and motor development in moderate to late preterm infants and term small for gestational age (SGA) infants.
- This study addresses these inconsistencies by comparing developmental outcomes.
Purpose of the Study:
- To compare neurological and motor function in preterm, term SGA, and term appropriate for gestational age (AGA) infants aged 3-7 months corrected age.
- To investigate the motor function of these groups at two years of age.
Main Methods:
- A prospective cohort study included 43 moderate to late preterm infants, 39 term SGA infants, and 170 term AGA infants.
- Neurological and motor function were assessed using Hammersmith Infant Neurological Examination (HINE), Test of Infant Motor Performance, General Movements Assessment, and Alberta Infant Motor Scale between 3-7 months corrected age.
- Motor function was assessed at two years using the Ages and Stages Questionnaire (ASQ-2).
Main Results:
- At 3-7 months corrected age, preterm infants had higher odds for HINE scores below the 10th percentile compared to term AGA infants.
- No significant differences were found in other infant assessment scores between the groups.
- At two years, preterm infants had significantly higher odds for gross motor scores below the ASQ-2 cut-off compared to term AGA infants.
Conclusions:
- Moderate prematurity is associated with subtle neurological differences in infancy.
- Preterm infants exhibit poorer gross motor function at two years compared to term AGA infants.
- Moderate prematurity poses a risk for neurological deficits extending to two years of age.
Background:
There are inconsistent findings regarding neurological and motor development in infants born moderate to late preterm and infants born small for gestational age at term. The primary aim of this study was to compare neurological and motor function between preterm, term SGA and term AGA infants aged three to seven months corrected age using several common assessment tools. The secondary aim was to investigate their motor function at two years.
Methods:
In this prospective cohort study, we included 43 infants born moderate to late preterm with gestational age 32-36 + 6 weeks, 39 infants born small for gestational age (SGA) at term with a birthweight ≤ 10th centile for gestational age, and 170 infants born at term with appropriate weight for gestational age (AGA). Neurological and motor function were assessed once in infancy between three to seven months corrected age by using four standardised assessment tools: Hammersmith Infant Neurological Examination (HINE), Test of Infant Motor Performance, General Movements Assessment and Alberta Infant Motor Scale. The Ages and Stages Questionnaire (ASQ-2) was used at two years.
Results:
At three to seven months corrected age, mean age-corrected HINE scores were 61.8 (95% confidence interval (CI): 60.5 to 63.1) in the preterm group compared with 63.3 (95% CI: 62.6 to 63.9) in the term AGA group. Preterm infants had 5.8 (95% CI: 2.4 to 15.4) higher odds for HINE scores < 10th percentile. The other test scores did not differ between the groups. At two years, the preterm group had 17 (95% CI: 1.9 to 160) higher odds for gross motor scores below cut-off on ASQ-2 compared with the term AGA group.
Conclusions:
The present study found subtle differences in neurological function between preterm and term AGA infants in infancy. At two years, preterm children had poorer gross motor function. The findings indicate that moderate prematurity in otherwise healthy infants pose a risk for neurological deficits not only during the first year, but also at two years of age when compared with term AGA children.
