Long-term motor outcomes of very preterm and/or very low birth weight individuals without cerebral palsy: A review of the current evidence

Marjaana Tikanmäki,Tordis Ustad,Peija Haaramo,Eero Kajantie,Kari Anne I. Evensen

doi:10.1016/j.siny.2020.101116

Abstract

We reviewed literature on long-term motor outcomes of individuals aged five years or older born very preterm (VP: ≤32 weeks of gestation) or with very low birth weight (VLBW: ≤1500g), without cerebral palsy (CP). PubMed produced 2827 articles, whereof 38 were eligible. Assessed by standardised and norm-based motor tests, the Movement Assessment Battery for Children being the most widely used, VP/VLBW individuals showed poorer motor skills compared with term-born controls with differences of approximately 1 SD in magnitude. Some studies assessed subdomains and differences were present in fine motor/manual dexterity, ball skills and gross motor/balance. Prevalence of motor problems varied largely from 8-37% in studies with cut-off at the 5th percentile or −1.5 SD to 12–71% in studies with cut-off at the 15th percentile or −1 SD. This review shows that the degree of motor impairments continues to be substantial among VP/VLBW individuals who do not develop CP.

Highlights

Motor function is one of the very early signs of typical or adverse neurodevelopment in the child's first year of life [1]
We aimed to review long-term motor outcomes including domainspecific motor skills, assessed by standardised motor tests, of very preterm (VP)/very low birth weight (VLBW) children with no manifest cerebral palsy (CP) compared with term-born controls
One author (KAIE) conducted the initial screening of titles and abstracts, using the following inclusion criteria: exposure was VP/VLBW, age of assessment ≥5 years, motor outcome was assessed by a standardised and norm-based motor test, the results were reported as continuous scores compared with a control group or as proportion of children with motor problems according to a defined cut-off

Summary

Introduction

Motor function is one of the very early signs of typical or adverse neurodevelopment in the child's first year of life [1]. Most children do not develop CP [2], and minor motor problems might not be evident before early school age when being competent in various motor skills becomes increasingly important for everyday life activities [2]. Ball skills include both fine and gross motor skills, and are important for many sports and leisure activities as the child grows older. Motor problems have been consistently reported in children born very preterm (VP: ≤32 weeks) and/or with very low birth weight (VLBW: ≤1500 g). Rates of adverse neurodevelopmental outcomes have been relatively stable, with a slight decrease in moderate to severe CP [3,4,5] and an increase in non-CP motor impairment among extremely preterm (EP: ≤28 weeks) and/or extremely low birth weight (ELBW: ≤1000g) [6,7]

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