Gross Motor Outcomes of Children Born Prematurely in Northern Ontario and Followed by a Neonatal Follow-Up Programme

Abstract

Purpose: The developing brain of a premature infant is vulnerable to injury. As a result, the long-term consequences of a premature birth include motor deficits, cognitive and behavioural problems. It is crucial to identify motor dysfunction during the preschool period because it interferes with a child's ability to explore the world. The goals of this study were to (1) provide preliminary data on the gross motor outcomes of children born prematurely and (2) determine the proportion and characteristics of the children who had maintained delays over the course of follow-up. Method: A retrospective chart review was conducted on all infants monitored by a neonatal follow-up programme. Each child was assessed by a single physiotherapist from birth until age 2 years. Of the 107 cases identified, 97 individuals were retained for analysis; they had a mean gestational age of 31.1 (SD 2.9) weeks and a mean birth weight of 1.66 (SD 0.53) kilograms. Results: The majority of children assessed were found to have gross motor outcomes in the average range. Children with scores below the average range were most often born very preterm (VPT) or moderately preterm (MPT), with very low or low birth weight, respectively. A total of 17 participants were referred to physiotherapy to address the gross motor delays identified in the follow-up programme; 14 of these 17 had previously been identified as delayed and were being monitored. Late preterm (LPT) children (n=6) were most often referred, followed by those born extremely preterm (EPT) and VPT (n=4). In total, 56 children were identified as delayed at one assessment point but were found to be within normal limits by the end of the follow-up period. Conclusion: It is important to periodically monitor premature children. A longitudinal, population-based study is also needed to provide more data on the predictors and long-term motor outcomes of MPT and LPT children.

Motor Profile of Late Preterm Infants: A Systematic Review of the Last Decade

“…• Late preterm infants remain at risk of motor and developmental delays at the 4, 6, 8, 12, 24 and 36 months of age [7] [10] [12] [13] [23].…”

“…• Small for gestation Age (SGA) infants confronted the same motor and developmental difficulties with very preterm infants and constituted a significant factor of delays [7] • Factors such as mothers academic level, delivery status, nursing in intensive care unit, breastfeeding, gender and other neonatal and maternal factors stay under investigation as results were doubtful [10] [12] [19].…”

“…Also [12] did not find any association between mothers' educational level, intensive care unit and breastfeeding and developmental delays. In contrast, [7] whose results indicated that SGA was significant factor and [10] who mentioned that gender (male)emergent cesarean section and higher maternal education were associated with low developmental scores at 12 months of age for the late preterm infants.…”

“…Significant lower scores between late preterm and full-term infants were mentioned at both gross and fine domain. [7] assessed 15 extremely preterm infants, 34 very preterm infants, 25 medium preterm infants and 23 late preterm infants, including SGA. They used the Alberta Infant Motor Scale (AIMS) [8] and the Early Intervention Developmental Profile (EIDP) [9].…”

Factors associated with the Dubowitz neurological examination in preterm new-borns

“…Additionally, the most common consequence of premature birth for mothers is vaginal and urinary tract infection, conditions that require consistent care (Aguilera et al, 2019). Premature birth often entails neonatal intensive attention, enhancing the chances for serious complications, including neonatal sepsis (Jiang et al, 2020), retinopathy (Palmer et al, 2020), intraventricular haemorrhage or periventricular leukomalacia (Khazanchi et al, 2020), and neuropsychomotor complications (Bélanger et al, 2018).…”