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
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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