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, S. J.
AU - Ådén, Ulrika
AU - Cuttini, Marina
AU - Koopman-Esseboom, Corine
AU - Lebeer, J.
AU - Varendi, H.
AU - Zemlin, M.
AU - Pierrat, V.
AU - Zeitlin, Jennifer
AU - Lebeer, J.
AU - Van Reempts, P.
AU - Bruneel, E.
AU - Cloet, E.
AU - Oostra, A.
AU - Ortibus, E.
AU - Sarrechia, I.
AU - Boerch, K.
AU - Pedersen, P.
AU - Toome, L.
AU - Varendi, H.
AU - Männamaa, M.
AU - Ancel, P. Y.
AU - Burguet, A.
AU - Jarreau, P. H.
AU - Pierrat, V.
AU - Truffert, P.
AU - Maier, R. F.
AU - Zemlin, M.
AU - Misselwitz, B.
AU - Wohlers, L.
AU - Cuttini, M.
AU - Croci, I.
AU - Carnielli, V.
AU - Ancora, G.
AU - Faldella, G.
AU - Ferrari, F.
AU - van Heijst, A.
AU - Koopman-Esseboom, C.
AU - Gadzinowski, J.
AU - Mazela, J.
AU - Montgomery, A.
AU - Pikuła, T.
AU - Barros, H.
AU - Costa, R.
AU - Rodrigues, C.
AU - Aden, U.
AU - Draper, E. S.
AU - Fenton, A.
AU - The SHIPS Research Group
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.
PY - 2023
Y1 - 2023
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 - Journal article
C2 - 36694025
AN - SCOPUS:85146764280
JO - Pediatric Research
JF - Pediatric Research
SN - 0031-3998
ER -