Motor skills at 23 years of age in young adults born preterm with very low birth weight

Ingrid Marie Husby,Jon Skranes,Alexander Olsen,Ann-Mari Brubakk,Kari Anne I Evensen

doi:10.1016/j.earlhumdev.2013.05.009

Abstract

BackgroundMotor skills have previously not been reported in young adults born with very low birth weight (VLBW), although they are commonly reported in children and adolescents. AimTo compare fine and gross motor skills in VLBW young adults with matched term-born controls, and to study longitudinal changes in the VLBW group. Study designA geographically based follow-up study of a VLBW group and a control group. SubjectsThirty-six VLBW (birth weight≤1500g) young adults, including four participants with cerebral palsy (CP), and 37 matched controls (birth weight≥10th centile) were examined at 14 and 23years of age. Outcome measuresFine and gross motor skills were assessed using Grooved Pegboard test (GP), Trail Making Test-5 (TMT-5), Movement Assessment Battery for Children-2 (Movement ABC-2) and High-level Mobility Assessment Tool (HiMAT). ResultsVLBW young adults were slower than controls on GP (p=0.026) and TMT-5 (p<0.001). Mean total Movement ABC-2 score was 69.7±20.2 in the VLBW group compared with 74.1±14.4 in the control group (p=0.017). Differences were also seen in manual dexterity and balance. Additionally, HiMAT showed reduced balance and speed in gross motor skills in the VLBW group. The proportion of participants with motor problems did not change between age 14 and 23. After exclusion of participants with CP, scores were essentially the same. ConclusionVLBW young adults had overall poorer fine and gross motor skills compared with controls. Reduced speed seemed to be an underlying problem. Longitudinal findings indicate that VLBW children have not outgrown their motor problems when entering adulthood.

Highlights

Perspective Globally, about 15 million children are born preterm each year, representing a preterm birth rate of 11.1%31
very low birth weight (VLBW) young adults showed persisting and possibly increasing white matter alterations compared with the control group, and these alterations were associated with poorer motor function. These findings indicate that white matter alterations have an impact on outcome in VLBW young adults and that the transition to adulthood seems to be especially challenging for VLBW individuals
In conclusion, VLBW young adults had poorer fine and gross motor skills compared with a term-born control group at 23 years, and they did not show any improvements in motor skills from adolescence into young adulthood

Summary

Introduction

Perspective Globally, about 15 million children are born preterm each year, representing a preterm birth rate of 11.1%31. Preterm birth disrupts the normal maturation of white matter, and the preterm brain typically exhibits lower FA and higher MD compared with term-born controls at birth These DTI changes persist into adolescence and young adulthood (Li et al, 2014; Pandit et al, 2013). Aim: To compare fine and gross motor skills in VLBW young adults with matched term-born controls, and to study longitudinal changes in the VLBW group. The preterm brain is especially vulnerable to injury and developmental disturbances [1], increasing the risk of later neurodevelopmental problems [2, 3] This may have an impact on mental health and health-related quality of life (HRQoL); studies on long-term effects of VLBW into adulthood are sparse and yield mixed findings. Preterm birth is shown to have an adverse effect on educational attainment, income and establishment of a family [6], and mental health problems tend to persist or even increase into young adulthood [7–9]

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