Movement outcomes of infants born moderate and late preterm

Abstract

Aim: To investigate whether children born between 32 and 36 weeks of gestation have an increased risk of motor coordination difficulties or cerebral palsy (CP) at age 7 years.

Methods: A cohort study based on the Avon Longitudinal Study of Parents and Children (ALSPAC). The primary outcomes were poor motor coordination, defined as an ALSPAC coordination test score <5th centile or the presence of CP. Exposure groups were defined as moderate or late preterm (32-36 weeks of gestation) or term (37-42 weeks). Regression models were used to investigate the association between gestational age and outcomes. Multiple imputation was used to account for missing covariate data.

Results: In the fully adjusted model, there was strong evidence that children born at moderate or late preterm had worse coordination (OR 1.41 (1.14-1.74)) and higher risk of CP (OR 6.38 (2.28-17.76)) than term peers. However, restricting the analysis to well-grown infants born vaginally, in good condition, the associations attenuated substantially.

Conclusions: Moderate or late preterm infants were at increased risk of developing coordination problems and cerebral palsy. After restricting the analysis to 'well' infants the associations of gestation with the coordination measures and CP reduced substantially, suggesting that antenatal, intrapartum and neonatal causal pathways are likely to be involved.

Keywords: Avon longitudinal study of parents and children; Cerebral palsy; Cohort studies; Premature infants.