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Arch Dis Child. 2015 Aug;100(8):748-53. doi: 10.1136/archdischild-2014-307695. Epub 2015 Mar 17.

Predicting severe motor impairment in preterm children at age 5 years.

Collaborators (143)

D'Ilario J, Cairnie J, Dix J, Adams BA, Warriner E, Kim MH, 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 AM, Magrath E, Williamson A, Bairam A, Bélanger 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 AM, 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 JC, Dietz V, Harikumar C, Anderson PJ, Asztalos EV, Barrington KJ, Davis PG, Doyle LW, Ohlsson A, Solimano A, Gent M, Fraser W, Hey E, Thorpe K, Gray S, Roberts RS, Chambers C, Costantini L, Yacura W, McGean E, Scapinello L.

Author information

1
Department of Pediatrics, University of British Columbia, and Child and Family Research Institute, Vancouver, British Columbia, Canada.
2
Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia Departments of Obstetrics and Gynaecology and Paediatrics, University of Melbourne, Melbourne, Australia.
3
Alberta Children's Hospital Research Institute for Child and Maternal Health and Departments of Pediatrics and Community Health Services, University of Calgary, Calgary, Alberta, Canada.
4
Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada.
5
Department of Paediatrics, James Cook University Hospital, Middlesbrough, UK.
6
Departments of Obstetrics and Gynaecology and Paediatrics, University of Melbourne, Melbourne, Australia.
7
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
8
McGill University Health Centre, Montreal, Quebec, Canada.
9
Windsor Regional Hospital, Windsor, Ontario, Canada.
10
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada Division of Neonatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Abstract

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.

TRIAL REGISTRATION NUMBER:

ClinicalTrials.gov number NCT00182312.

KEYWORDS:

Neonatology; Neurodevelopment; Outcomes research

[Indexed for MEDLINE]

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