Prediction of movement difficulties at 5 years from parent report at 2 years in children born extremely preterm

Area of Science:

• Pediatric neurology
• Developmental pediatrics
• Neonatology

Background:

• Extremely preterm infants face higher risks of developmental impairments.
• Early identification of motor deficits is crucial for timely intervention.

Purpose of the Study:

• To evaluate the predictive accuracy of parent-reported gross motor impairment (GMI) at age 2 years for detecting significant movement difficulties at age 5 years in extremely preterm children.

Main Methods:

• A cohort of 556 extremely preterm children (born <28 weeks gestation) across 10 European countries was studied.
• Parental reports of GMI (walking unsteadily or unable to walk unassisted) at 2 years corrected age were collected.
• Movement difficulties (Movement Assessment Battery for Children, Second Edition ≤5th percentile) and cerebral palsy (CP) diagnoses were assessed at 5 years chronological age.

Main Results:

• At 2 years, 11.9% of children had moderate/severe GMI. At 5 years, 38.1% had significant movement difficulties.
• Parent reports of GMI at 2 years showed high specificity (96.2%) and positive predictive value (80.3%) for significant movement difficulties at 5 years.
• However, sensitivity was low (25.1%), with 74.5% of children experiencing movement difficulties at 5 years not identified by parental GMI report at 2 years.

Conclusions:

• Parental questionnaires for GMI at age 2 years can help identify extremely preterm children with CP or significant motor challenges impacting functional outcomes at age 5 years.
• The low sensitivity suggests this screening tool may miss a substantial proportion of children with later movement difficulties.