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Neonatal Neuroimaging Among Children Born Extremely Preterm and Motor Coordination Impairment at School-Age

Susan R Hintz1, Carla M Bann2, Betty R Vohr3

  • 1Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA.

The Journal of Pediatrics
|June 26, 2025
PubMed

Insights

Motor coordination impairment affects many extremely preterm infants, regardless of early brain imaging results. Consistent long-term follow-up and intervention are crucial for these children.

Area of Science:

  • Neonatal neurology
  • Developmental pediatrics
  • Neuroimaging

Background:

  • Extremely preterm infants face risks for neurodevelopmental deficits.
  • Cranial ultrasound (CUS) and MRI are used to assess brain development in neonates.
  • White matter abnormalities (WMA) on imaging are potential markers for later motor impairments.

Purpose of the Study:

  • To investigate the association between neonatal neuroimaging findings (CUS and MRI) and motor coordination impairment at school age in extremely preterm children.
  • To determine if WMA on brain MRI are predictive of motor deficits.
  • To assess the prevalence of motor impairment in relation to neuroimaging results.

Main Methods:

  • Prospective, longitudinal study of infants born 24-27 weeks estimated gestational age (EGA).
  • Neonatal CUS and near-term MRI were performed.
  • Motor function assessed at 6-7 years using the Movement Assessment Battery for Children (MABC-2).
  • Logistic regression analyzed associations between neuroimaging and motor outcomes.

Main Results:

  • Nearly one-third of extremely preterm children exhibited significant motor impairment.
  • Motor impairment rates increased with lower EGA.
  • Adverse late CUS findings and WMA severity were associated with higher impairment rates.
  • Importantly, significant motor impairment was also prevalent in children with normal late CUS (29%) and no WMA on MRI (22%).
  • Motor impairment was independently linked to adverse late CUS and moderate-severe WMA in children without cerebral palsy.

Conclusions:

  • Motor coordination impairment is common in extremely preterm infants, irrespective of neonatal neuroimaging abnormalities.
  • Neonatal brain imaging findings are associated with, but do not fully predict, motor deficits.
  • Emphasizes the necessity for ongoing developmental surveillance and early intervention for all extremely preterm infants.
Abstract

Keywords:
brain imagingdevelopmental coordination disorderextreme prematurityneurodevelopmental outcome

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