Predictive value of early motor evaluation in preterm very low birth weight and term small for gestational age children

Background: Motor problems are common in children born preterm or small for gestational age. Aim: To study the predictive value of early motor assessments for later motor skills. Subjects: Twenty-eight children born preterm with very low birth weight (VLBW: birth weight <= 1500 g) 57 children born small for gestational age (SGA: birth weight <10th centile) at term and 77 term-born controls with normal birth weight. Methods: The psychomotor development index (PDI) of the Bayley Scales of Infant Development was used as a measure of motor skills at age one, the Peabody Developmental Motor Scales (PDMS) at age five and the Movement Assessment Battery for Children (Movement ABC) at age 14. Low/borderline low scores were defined as < - 25D/- 1SD (PDI) or <5th/15th centile (PDMS; Movement ABC). Results: In the VLBW group, motor problems in adolescence were identified both by low PDI (sensitivity: 0.80; 95%CI:0.38-0.96) and PDMS scores (sensitivity: 0.83; 95%CI:0.44-0.97). In the SGA and the control group sensitivity was poor for low PDI and moderate for low PDMS scores. However, in the SGA group. sensitivity increased when borderline low PDMS scores were used as cut-off (sensitivity: 0.75; 95%CI:0.41-0.93). Specificity of PDI and PDMS was high in all three groups. Conclusions: Both PDI and PDMS may be valuable tools for early identification of motor problems in VLBW children. whereas PDMS best predicted motor problems in the two other groups. In all three groups, a normal motor examination at 1 and 5 years was highly predictive of normal motor skills at age 14. (C) 2009 Elsevier Ireland Ltd. All rights reserved.