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Risk factors for cerebral palsy and movement difficulties in 5-year-old children born extremely preterm

Lookup NU author(s): Dr Alan Fenton

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Abstract

© 2023, The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.Background: Motor impairment is common after extremely preterm (EPT, <28 weeks’ gestational age (GA)) birth, with cerebral palsy (CP) affecting about 10% of children and non-CP movement difficulties (MD) up to 50%. This study investigated the sociodemographic, perinatal and neonatal risk factors for CP and non-CP MD. Methods: Data come from a European population-based cohort of children born EPT in 2011–2012 in 11 countries. We used multinomial logistic regression to assess risk factors for CP and non-CP MD (Movement Assessment Battery for Children – 2nd edition ≤5th percentile) compared to no MD (>15th percentile) among 5-year-old children. Results: Compared to children without MD (n = 366), young maternal age, male sex and bronchopulmonary dysplasia were similarly associated with CP (n = 100) and non-CP MD (n = 224) with relative risk ratios (RRR) ranging from 2.3 to 3.6. CP was strongly related to severe brain lesions (RRR >10), other neonatal morbidities, congenital anomalies and low Apgar score (RRR: 2.4–3.3), while non-CP MD was associated with primiparity, maternal education, small for GA (RRR: 1.6–2.6) and severe brain lesions, but at a much lower order of magnitude. Conclusion: CP and non-CP MD have different risk factor profiles, with fewer clinical but more sociodemographic risk factors for non-CP MD. Impact: Young maternal age, male sex and bronchopulmonary dysplasia similarly increased risks of both cerebral palsy and non-cerebral palsy movement difficulties.Cerebral palsy was strongly related to clinical risk factors including severe brain lesions and other neonatal morbidities, while non-cerebral palsy movement difficulties were more associated with sociodemographic risk factors.These results on the similarities and differences in risk profiles of children with cerebral palsy and non-cerebral palsy movement difficulties raise questions for etiological research and provide a basis for improving the identification of children who may benefit from follow-up and early intervention.

Publication metadata

Author(s): Aubert AM, Costa R, Johnson S, Aden U, Cuttini M, Koopman-Esseboom C, Zemlin M, Pierrat V, Zeitlin J, Lebeer J, Lebeer J, Van Reempts P, Bruneel E, Cloet E, Oostra A, Ortibus E, Sarrechia I, Boerch K, Pedersen P, Toome L, Varendi H, Varendi H, Mannamaa M, Ancel PY, Burguet A, Jarreau PH, Pierrat V, Truffert P, Maier RF, Zemlin M, Misselwitz B, Wohlers L, Cuttini M, Croci I, Carnielli V, Ancora G, Faldella G, Ferrari F, van Heijst A, Koopman-Esseboom C, Gadzinowski J, Mazela J, Montgomery A, Pikula T, Barros H, Costa R, Rodrigues C, Aden U, Draper ES, Fenton A, Johnson SJ, Mader S, Thiele N, Pfeil JM, Petrou S, Kim SW, Andronis L, Zeitlin J, Aubert AM, Bonnet C, El Rafei R, Seppanen AV

Publication type: Article

Publication status: Published

Journal: Pediatric Research

Year: 2023

Volume: 94

Pages: 771–780

Print publication date: 01/08/2023

Online publication date: 24/01/2023

Acceptance date: 19/11/2022

ISSN (print): 0031-3998

ISSN (electronic): 1530-0447

Publisher: Springer Nature

URL: https://doi.org/10.1038/s41390-022-02437-6

DOI: 10.1038/s41390-022-02437-6

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