Abstract
ObjectiveThis study aimed to define the prevalence and predictors of non-right-handedness and its link to long-term neurodevelopmental outcome and early neuroimaging in a cohort of children born extremely preterm (<28 weeks gestation).Methods179 children born extremely preterm admitted to the Neonatal Intensive Care Unit of our tertiary centre from 2006–2013 were included in a prospective longitudinal cohort study. Collected data included perinatal data, demographic characteristics, neurodevelopmental outcome measured by the Bayley Scales of Infant and Toddler Development at 2 years and the Movement Assessment Battery for Children at 5 years, and handedness measured at school age (4–8 years). Magnetic resonance imaging performed at term-equivalent age was used to study overt brain injury. Diffusion tensor imaging scans were analysed using tract-based spatial statistics to assess white matter microstructure in relation to handedness and neurodevelopmental outcome.ResultsThe prevalence of non-right-handedness in our cohort was 22.9%, compared to 12% in the general population. Weaker fine motor skills at 2 years and paternal non-right-handedness were significantly associated with non-right-handedness. Both overt brain injury and fractional anisotropy of white matter structures on diffusion tensor images were not related to handedness. Fractional anisotropy measurements showed significant associations with neurodevelopmental outcome.ConclusionsOur data show that non-right-handedness in children born extremely preterm occurs almost twice as frequently as in the general population. In the studied population, non-right-handedness is associated with weaker fine motor skills and paternal non-right-handedness, but not with overt brain injury or microstructural brain development on early magnetic resonance imaging.
Highlights
In Europe, preterm birth accounts for 5.5–11.1% of all live births (2008) [1]
Weaker fine motor skills at 2 years and paternal non-right-handedness were significantly associated with non-right-handedness
For 179 extremely preterm (EPT) children, data on hand preference could be obtained during the MABC-2-NL
Summary
In Europe, preterm birth accounts for 5.5–11.1% of all live births (2008) [1]. Health care for these vulnerable children improved over the past decades and survival chances are still increasing. One of the less obvious differences between preterm and term born children is the higher prevalence of non-right-handedness (NRH), a combination of left- and mixed-handedness. Different hypotheses explaining the underlying mechanisms of the increased NRH prevalence in children born preterm have been proposed: genetic predisposition, brain pathology, or a combination of both [3]. The factors sex and parental handedness have been suggested to be associated with NRH in both the general and ex-preterm populations [4,5,6,7,8,9,10,11,12]
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