Comparing Standardized and Parent-Reported Motor Outcomes of Extremely Preterm Infants.

Maeve Morgan-Feir,Dianne Creighton,Thevanisha Pillay,Anne Synnes,Andrea Abbott,Jill G Zwicker

doi:10.3390/children6080090

Abstract

Extremely preterm infants are at increased risk of motor impairment. The Canadian Neonatal Follow-Up Network (CNFUN) afforded an opportunity to study the outcomes of extremely preterm children. The purpose of this study was to compare 18-month corrected age (CA) motor outcomes of extremely preterm infants with parent-reported functional outcomes at 3 years CA. CNFUN data of 1376 infants were used to conduct chi-square analyses to compare Bayley-III motor scores (composite, gross, and fine motor) at 18 months CA with parent-reported Ages and Stages Questionnaire motor scores (gross and fine motor) at 3 years CA. The correlation of motor scores at 18-months CA with parent-reported gross and fine motor scores at 3 years CA was also examined. We found that 1 in 5 infants scoring within or above the average range on the Bayley-III had parent-reported functional fine and gross motor difficulties at 3 years CA. Bayley-III scores were only moderately correlated with functional motor outcomes. Results of the study suggest that the Bayley-III at 18 months CA was able to detect the majority of infants with motor problems, but not all; therefore, ongoing follow-up of extremely preterm infants is required. The Bayley-III motor composite score has greater clinical utility compared to sub-scale scores.

Highlights

Preterm infants are at high risk for adverse neurodevelopmental outcomes such as visual, hearing, language, motor, and cognitive impairments that emerge in early childhood, requiring regimented follow-up and assessment [1,2]
While increased and extended standardized assessment of extremely preterm infants may represent a cost to the healthcare system, this suggests that increased parent-reported assessment may pose a low-cost alternative allowing for extended follow-up
The Bayley-III motor composite score had the strongest correlation with the ASQ-3 results, suggesting a greater clinical utility of the Bayley-III motor composite score compared to fine and gross motor sub-scale scores

Summary

Introduction

Preterm infants are at high risk for adverse neurodevelopmental outcomes such as visual, hearing, language, motor, and cognitive impairments that emerge in early childhood, requiring regimented follow-up and assessment [1,2]. Motor impairments in children born extremely preterm include cerebral palsy and developmental coordination disorder [3,4]. In Canada, children who are born extremely preterm are referred to neonatal follow-up clinics that aim to investigate the effects of neonatal practices, detect impairments early, promote early intervention, and provide training to healthcare professionals. Practices vary between neonatal follow-up programs [5], most children born extremely preterm are eligible for a standardized neurodevelopmental assessment at 18 months corrected age (CA). With 26 contributing sites in Canada, the CNFUN provides a unique opportunity to study the motor outcomes of extremely preterm children in a large national sample

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