Are behaviour problems in extremely low-birthweight children related to their motor ability?

Motor outcomes of children born extremely preterm; from early childhood to adolescence

Children and adolescents born extremely preterm (EP; <28 weeks' gestation) are at greater risk of motor impairment, including cerebral palsy and developmental coordination disorder, than their term born peers. Importantly, motor impairment has implications beyond performing motor skills; it negatively affects outcomes as diverse as school success, emotional wellbeing, physical health, and physical activity (PA) participation. This review will outline what is known about PA participation across childhood and adolescence for children born EP and term, recognising that PA may improve physical, social, and mental health outcomes. Critically, PA participation occurs in the context of children's and adolescents' daily lives, and is influenced by the family, social and physical environment, as well as by the child's personal factors, such as motor impairment. Further research is needed to better understand PA participation levels and correlates for children and adolescents born preterm, to better inform effective and sustainable interventions.

[Formula: see text] Social-environmental moderators of neurodevelopmental outcomes in youth born preterm: A systematic review

Objective: Preterm birth represents a significant medical event that places infants at a markedly greater risk for neurodevelopmental problems and delays. Although the impact of medical factors on neurodevelopment for those born preterm has been thoroughly explored, less is known about how social-environmental factors (e.g., socioeconomic status, family functioning) moderate outcomes. This review explores the quantity and methodological rigor of research on social-environmental factors as moderators of the relationship between preterm birth and neurodevelopmental outcomes.Methods: Articles published between January 1980 and December 2016 were identified from a comprehensive meta-analysis and systematic review on neurodevelopmental outcomes following preterm birth. A systematic review of MEDLINE was conducted to identify articles published from January 2017 through April 2019.Results: Eighty articles met the inclusion criteria. The majority of studies matched preterm and control groups on social-environmental factors (n = 49). The remaining studies included social-environmental factors as moderators (n = 13) or correlates (n = 11) of neurodevelopmental outcomes. Only seven studies did not include reports on social-environmental factors.Conclusions: This systematic review suggests that social-environmental factors are often considered to be ancillary risk factors to the larger medical risk imparted by prematurity. Studies typically focused on socioeconomic status rather than more modifiable parent/family factors that can be targeted through intervention (e.g., parental mental health) and evidenced mixed findings regarding the significance of social-environmental factors as moderators. Further research is needed to identify the relative influence of social-environmental factors to inform future psychosocial interventions.

The impact of choice of norms on classification of motor impairment for children born very preterm

BACKGROUND

The Movement Assessment Battery for Children-Second Edition (Movement ABC-2) is widely used to assess children's motor function, yet there is a lack of normative data for many countries.

AIMS

To assess the extent to which the application of different population reference norms for the Movement ABC-2 affects the classification and prevalence of motor impairment.

DESIGN

Data were obtained from two Portuguese regions participating in the Screening to Improve Health in Very Preterm Infants in Europe (SHIPS) Study, which was a five year follow-up of a cohort of children born at <32 weeks' gestation in 2011-2012 in 19 regions in 11 European countries. Perinatal data were extracted from medical records and the Movement ABC-2 was administered at five years of age.

SUBJECTS

Of 542 Portuguese children eligible for the five-year follow-up, 413 (76.2%) were evaluated.

OUTCOME MEASURES

Movement ABC-2 raw scores were converted to standardized scores using norms from four countries with national standardisations (UK, Netherlands/Belgium, France and Italy).

RESULTS

The prevalence of significant movement difficulties (total score ≤ 5th percentile) was 28.5% using Dutch/Flemish norms, 23.3% using French norms, 16.5% using UK norms and 11.4% using Italian norms; 10.8% and 68.3% of the children were consistently classified as having significant movement difficulties and as not having significant movement difficulties, respectively, according to any norms. However, for 20.9% of children there was a disagreement in motor function status using different norms.

CONCLUSION

The use of different test norms has a large impact on the proportion of children classified with significant movement difficulties, with implications for clinical referrals, healthcare costs and research. Our results underscore the importance of using appropriately validated tests with sound psychometric properties, and raise questions about the large differences in norms for the Movement ABC-2 in European countries.