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Motor difficulties and associated risk factors at 12 years in children born extremely preterm: a population-based
Maria Örtqvist1,2, Nelly Padilla3, Cecilia Montgomery4,5
1Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden maria.ortqvist@ki.se.
Insights
Extremely preterm (EPT) children face a significantly higher risk of motor difficulties by age 12 compared to term-born peers. Early detection and intervention are crucial for these children, even without severe impairments.
Area of Science:
- Pediatric neurology
- Developmental pediatrics
- Public health
Background:
- Extremely preterm (EPT) birth (<28 weeks' gestational age) is associated with increased risks of neurodevelopmental challenges.
- Motor difficulties can impact a child's overall development and quality of life.
- Long-term outcomes for EPT survivors require ongoing investigation.
Purpose of the Study:
- To assess the prevalence of significant motor difficulties in 12-year-old children born EPT compared to term-born controls.
- To identify risk factors and comorbidities associated with motor difficulties in EPT survivors.
- To inform follow-up strategies for EPT children.
Main Methods:
- Population-based cohort study of EPT and term-born children in Sweden (2004-2007 births).
- Motor function assessed at 12 years using the Movement Assessment Battery for Children, second edition (MABC-2).
- Logistic regression analysis to determine risk factors for motor difficulties.
Main Results:
- 30% of EPT-born children exhibited significant motor difficulties versus 3% of term-born peers (aOR 16.99).
- Male sex and lower gestational age were independent risk factors for motor difficulties in EPT children.
- Comorbidities like autism spectrum and ADHD were common; only 9.5% received physiotherapy.
Conclusions:
- EPT children, even without cerebral palsy or severe neurodevelopmental impairment, have a substantially higher risk of motor difficulties at age 12.
- Associated neurodevelopmental comorbidities are frequent in EPT children with motor challenges.
- Structured follow-up into mid-school age is essential for timely intervention in EPT survivors.
Objective:
To determine the prevalence of significant motor difficulties at 12 years of age in children born extremely preterm (EPT, <28 weeks' gestational age) compared with term-born peers and to identify associated risk factors and comorbidities.
Design:
Population-based cohort study.
Setting:
National cohort from the Extremely Preterm Infants in Sweden Study, including children born from 2004 to 2007.
Patients:
Children born <27 weeks' gestational age without cerebral palsy and/or severe neurodevelopmental impairment and term-born controls.
Interventions:
Motor function was assessed at 12 years using the Movement Assessment Battery for Children, second edition (MABC-2). Logistic regression identified risk factors for motor difficulties.
Main Outcome Measures:
Prevalence of significant motor difficulties, defined as scores ≤fifth percentile on MABC-2.
Results:
A total of 268 EPT-born and 196 term-born children were assessed. Significant motor difficulties were found in 30% of EPT-born children compared with 3% of term-born peers (adjusted OR 16.99; 95% CI 6.64 to 43.47). Male sex and lower gestational age were independently associated with higher risk. Among EPT-born children with motor difficulties, comorbidities were common, including autism spectrum disorders and attention deficit hyperactivity disorders. Only 9.5% of affected children had received physiotherapy in the previous year.
Conclusions:
Children born EPT, even in the absence of cerebral palsy and/or severe neurodevelopmental impairment, have a markedly increased risk of motor difficulties and associated neurodevelopmental comorbidities by age 12. Structured follow-up into mid-school age is essential to enable timely interventions.
