The purposes of this study were to (1) assess the prevalence of risk factors in children born before 32 weeks of gestation in Iceland, (2) determine the percentage of the children identified with a neurodevelopmental diagnosis and those that are referred to interventions, and (3) examine gross motor development in extremely preterm children born before the 28th week and those with extremely low birth weight (1000 g) over two years, and explore the relationship between health-related complications and motor development at 12- and 24-months corrected age.
This longitudinal retrospective cohort study used data from children born before 32 weeks, who attended a multidisciplinary developmental follow-up at the Icelandic National Hospital between 2011-2020. In the follow-up visits, the physiotherapists assessed gross motor development in children born before 28 weeks or with extremely low birthweight (1000 g) with The Alberta Infant Motor Scale (AIMS) at few months intervals for the first 15 months of life. Gross and fine development were assessed with the Bayley Scales of Infant and Toddler Development III (BSID-III) at 12- and 24-months corrected age.
The prevalence of neurodevelopmental diagnosis and intervention referrals of children born before 32 weeks were calculated. The AIMS scores were compared with normative data using the Dunnett T3 test, and the BSID-III scores were compared with reference scores using a one-sample t-test. Correlation tests and multiple linear regression explored the impact of health complications on motor outcomes.
The data set included total 318 children. The number of infants assessed with AIMS varied at each time point. At approximately 12 months, 81 completed the BSID-III assessment, and at around 24 months, 60 children were evaluated. Health complications were more common among children born before 28 weeks, who also had higher rates of CP and developmental disorders (29.4% and 9,4% respectively) as well as a higher number of intervention referrals.
Infants born before 28 weeks or with extremely low birth weight had significantly lower AIMS scores at age ranges 4-7, 8-9 and 12-13-months corrected age. At 12- and 24-months corrected age, the BSID-III scores of the children were significantly lower (M=89.8 and 94.3 respectively) compared to normative scores (M=100) (p=.001). Regression analysis indicated that health-related factors did not predict motor outcomes at 12- and 24-months of age.
Children born extremely preterm or with extremely low birth weight exhibited significant delays in motor development. Shorter gestational age was associated with a higher prevalence of health complications, but these did not predict the motor outcomes at 12- and 24-months. Further research is needed to assess how early motor delays affect later development and if health-related complications account for developmental problems beyond the first two years.
Children, particularly those born extremely preterm or with extremely low birth weight, require close monitoring. Early detection of adverse events and early intervention promotes better long-term outcomes.
health care
motor development
