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Predicting severe motor impairment in preterm children at age 5 years

Lookup NU author(s): Dr Win Tin, Unni Wariyar OBE, Professor Nicholas EmbletonORCiD, Dr Ravi Swamy, Dr C Harikumar


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Objective To determine whether the ability to predict severe motor impairment at age 5 years improves between birth and 18 months. Design Ancillary study of the Caffeine for Apnea of Prematurity Trial. Setting and Patients International cohort of very low birth weight children who were assessed sequentially from birth to 5 years. Outcome Measures Severe motor impairment was defined as a score <5th percentile on the Movement Assessment Battery of Children (MABC), or inability to complete the MABC because of cerebral palsy. Multivariable logistic regression cumulative risk models used four sets of predictor variables: early neonatal risk factors, risk factors at 36 weeks' postmenstrual age, risk factors at a corrected age of 18 months, and sociodemographic variables. A receiver operating characteristic curve (ROC) was generated for each model, and the four ROC curves were compared to determine if the addition of the new set of predictors significantly increased the area under the curve (AUC). Results Of 1469 children, 291 (19.8%) had a severe motor impairment at 5 years. The AUC increased from 0.650 soon after birth, to 0.718 (p<0.001) at 36 weeks' postmenstrual age, and to 0.797 at 18 months ( p<0.001). Sociodemographic variables did not significantly improve the AUC (AUC=0.806; p=0.07). Conclusions Prediction of severe motor impairment at 5 years of age using a cumulative risk model improves significantly from birth to 18 months of age in children with birth weights between 500 g and 1250 g.

Publication metadata

Author(s): Synnes A, Anderson PJ, Grunau RE, Dewey D, Moddemann D, Tin W, Davis PG, Doyle LW, Foster G, Khairy M, Nwaesei C, Schmidt B, D'Ilario J, Cairnie J, Dix J, Adams BA, Warriner E, Kim M-HM, Argus B, Callanan C, Davis N, Duff J, McDonald M, Asztalos E, Hohn D, Lacy M, Haslam R, Barnett C, Goodchild L, Lontis RM, Fraser S, Keng J, Saunders K, Opie G, Kelly E, Woods H, Marchant E, Turner A-M, Magrath E, Williamson A, Bairam A, Belanger S, Fraser A, Blayney M, Lemyre B, Frank J, Solimano A, Hubber-Richard P, Rogers M, Mackay M, Petrie-Thomas J, Butt A, Van Wassenaer A, Nuytemans D, Houtzager B, Van Sonderen L, Regev R, Itzchack N, Arnon S, Chalaf A, Ohlsson A, O'Brien K, Hamilton A-M, Chan ML, Sankaran K, Proctor P, Golan A, Goldsch-Lerman E, Reynolds G, Dromgool B, Meskell A, Parr V, Maher C, Broom M, Kecskes Z, Ringland C, McMillan D, Spellen E, Sauve RS, Christianson H, Anseeuw-Deeks D, Creighton D, Heath J, Alvaro R, Chiu A, Porter C, Turner G, Granke N, Penner K, Bow J, Mulder A, Wassenberg R, Van Der Hoeven M, Clarke M, Parfitt J, Parker K, Ryan H, Saunders C, Schulze A, Wermuth I, Hilgendorff A, Flemmer AW, Herlenius E, Legnevall L, Lagercrantz H, Matthew D, Amos W, Tulsiani S, Tan-Dy C, Turner M, Phelan C, Shinwell ES, Levine M, Juster-Reicher A, Grier P, Vachon J, Perepolkin L, Barrington KJ, Sinha SK, Fritz S, Walti H, Royer D, Halliday H, Millar D, Mayes C, McCusker C, McLaughlin O, Fahnenstich H, Tillmann B, Weber P, Wariyar U, Embleton N, Swamy R, Bucher HU, Fauchere J-C, Dietz V, Harikumar C

Publication type: Article

Publication status: Published

Journal: Archives of Disease in Childhood

Year: 2015

Volume: 100

Issue: 8

Pages: 748-753

Print publication date: 01/08/2015

Online publication date: 17/03/2015

Acceptance date: 23/02/2015

ISSN (print): 0003-9888

ISSN (electronic): 1468-2044

Publisher: BMJ Publishing Group


DOI: 10.1136/archdischild-2014-307695

PubMed id: 25784749


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