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Motor Development in Very Preterm and Very Low-Birth-Weight Children From Birth to Adolescence: A Meta-analysis

Jorrit F. de Kieviet, MSc; Jan P. Piek, PhD; Cornelieke S. Aarnoudse-Moens, MSc; Jaap Oosterlaan, PhD
JAMA. 2009;302(20):2235-2242. doi:10.1001/jama.2009.1708.
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Context Infants who are very preterm (born ≤32 weeks of gestation) and very low birth weight (VLBW) (weighing ≤1500 g) are at risk for poor developmental outcomes. There is increasing evidence that very preterm birth and VLBW have a considerable effect on motor development, although findings are inconsistent.

Objective To investigate the relationship between very preterm birth and VLBW and motor development.

Data Sources The computerized databases EMBASE, PubMed, and Web of Knowledge were used to search for English-language peer-reviewed articles published between January 1992 and August 2009.

Study Selection Studies were included if they reported motor scores of very preterm and VLBW children without congenital anomalies using 1 of 3 established and widely used motor tests: the Bayley Scales of Infant Development II (BSID-II), the Movement Assessment Battery for Children (MABC), and the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP). Forty-one articles were identified, encompassing 9653 children.

Results In comparison with term-born peers, very preterm and VLBW children obtained significantly lower scores on all 3 motor tests: BSID-II: d = −0.88 (95% confidence interval [CI], −0.96 to −0.80; P < .001), MABC: d = −0.65 (95% CI, −0.70 to −0.60; P < .001), and BOTMP: d = −0.57 (95% CI, −0.68 to −0.46; P < .001). Whereas motor outcomes on the BSID-II show a catch-up effect in the first years of development (r = 0.50, P = .01), the results on the MABC demonstrate a nonsignificantly greater deficit with increasing age during elementary school and early adolescence (r = −0.59, P = .07).

Conclusion Being born preterm or VLBW is associated with significant motor impairment persisting throughout childhood.

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Figure 1. Effect Size and Heterogeneity Statistics for Bayley Scales of Infant Development II Ordered by Age at Assessment
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CI indicates confidence interval.

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Figure 2. Effect Sizes and Heterogeneity Statistics for the Movement Assessment Battery for Children Ordered by Age at Assessment
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CI indicates confidence interval.

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Figure 3. Effect Sizes and Heterogeneity Statistics for the Bruininks-Oseretsky Test of Motor Proficiency Ordered by Age at Assessment
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CI indicates confidence interval.

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