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A Meta-analysis

Jorrit F. de Kieviet, MSc; Jan P. Piek, PhD; Cornelieke S. Aarnoudse-Moens, MSc; Jaap Oosterlaan, PhD

JAMA. 2009;302(20):2235-2242.

Context  Infants who are very preterm (born 32 weeks of gestation) and very low birth weight (VLBW) (weighing 1500 g) are at risk for poor developmental outcomes. There is increasing evidence that very preterm birth and VLBW have a considerable effect on motor development, although findings are inconsistent.

Objective  To investigate the relationship between very preterm birth and VLBW and motor development.

Data Sources  The computerized databases EMBASE, PubMed, and Web of Knowledge were used to search for English-language peer-reviewed articles published between January 1992 and August 2009.

Study Selection  Studies were included if they reported motor scores of very preterm and VLBW children without congenital anomalies using 1 of 3 established and widely used motor tests: the Bayley Scales of Infant Development II (BSID-II), the Movement Assessment Battery for Children (MABC), and the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP). Forty-one articles were identified, encompassing 9653 children.

Results  In comparison with term-born peers, very preterm and VLBW children obtained significantly lower scores on all 3 motor tests: BSID-II: d = –0.88 (95% confidence interval [CI], –0.96 to –0.80; P < .001), MABC: d = –0.65 (95% CI, –0.70 to –0.60; P < .001), and BOTMP: d = –0.57 (95% CI, –0.68 to –0.46; P < .001). Whereas motor outcomes on the BSID-II show a catch-up effect in the first years of development (r = 0.50, P = .01), the results on the MABC demonstrate a nonsignificantly greater deficit with increasing age during elementary school and early adolescence (r = –0.59, P = .07).

Conclusion  Being born preterm or VLBW is associated with significant motor impairment persisting throughout childhood.

Author Affiliations: Department of Clinical Neuropsychology, VU University Amsterdam, Amsterdam, the Netherlands (Mr de Kieviet and Dr Oosterlaan); School of Psychology and Speech Pathology, Curtin Health Innovation Research Institute, Curtin University, Perth, Australia (Dr Piek); and Department of Pediatrics, Erasmus University Medical Centre/Sophia Children's Hospital, Rotterdam, the Netherlands (Ms Aarnoudse-Moens).

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