TY - JOUR
T1 - Risk factors for cerebral palsy and movement difficulties in 5-year-old children born extremely preterm
AU - Aubert, Adrien M.
AU - Costa, Raquel
AU - Johnson, Samantha
AU - Aden, U.
AU - Cuttini, M.
AU - Koopman-Esseboom, C.
AU - Lebeer, Jo
AU - Varendi, H.
AU - Zemlin, Michael
AU - Pierrat, V.
AU - Zeitlin, Jennifer
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.
PY - 2023/8
Y1 - 2023/8
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85146764280&partnerID=8YFLogxK
U2 - 10.1038/s41390-022-02437-6
DO - 10.1038/s41390-022-02437-6
M3 - Article
C2 - 36694025
AN - SCOPUS:85146764280
SN - 0031-3998
VL - 94
SP - 771
EP - 780
JO - Pediatric Research
JF - Pediatric Research
IS - 2
ER -