Introduction: Very low birth weight (VLBW) is a term used to describe babies who are born weighing less than 1,500 grams (3 pounds, 4 ounces). Infants who are born preterm with low birth weight and secondary to intrauterine growth restriction, can be subjected to increased morbidity, mortality, and cost . Babies with a very low birth weight are at a higher risk of motor development, depression, Attention deficits and other psychiatric conditions in adulthood, compared with those born a healthy weight . The purpose of this study is to find out the effect of very low birth weight and gestational age on motor development in preterm infants at 18 months of corrected age.
Materials and Methods: This study is a observational study design and was conducted in VAPMS College of Physiotherapy, outpatient Department and R.K. MISSION hospital. A study sample of 50 subjects was selected on simple random sampling method. The study questionnaire was applied and the infants were prospectively evaluated using Alberta Infant Motor Scale (AIMS) for their gross motor development at 18 months of corrected age. The observational study was done for 20 minutes for each infant. In addition, the perinatal and the socio-environmental data were obtained from the parental interview. The assessment emphasizes the anti gravity movement of the limbs in prone, supine, sitting and standing positions, postural alignment, weight bearing of the body with further evaluation in attainment of gross motor skills.
Results: The sample was segregated into three sub group model and thus identified 3 motor trajectories among VLBW preterm infants: stably normal (n=36), slightly deteriorating (n=11), persistently delayed (n = 3). Infants with a normal trajectory manifested the typical motor performance with AIMS Z scores of 0.4 to 0.5. Infants with deteriorating trajectory displayed the motor performance in the typical range initially but then deteriorated from 12 months. Infants with a persistently delayed trajectory revealed a significant delay from 9 months. All the infants were observed at 18 months of corrected age.
Conclusion: The study concluded that very low birth weight has a significant effect on the motor development observed in preterm infant. The early motor trajectories were also a predictive of subsequent developmental outcomes in preterm infants specifically with VLBW. In addition the study emphasizes that socio-environmental factors are not associated with motor trajectories in preterm infants with VLBW.
Keywords: Very low birth weight; Preterm infant; Gross motor trajectories
- Zelkowitz P. “Prematurity and its impact on psychosocial and emotional development in children”. Encyclopedia of Early Childhood Development (2017): 1-3.
- Singer L., et al. “A longitudinal study of developmental outcome of infants with bronchopulmonary dysplasia and very low birth weight”. Pediatrics 100.6 (1997): 987-93.
- Platt MJ. “Outcomes in preterm infants”. Public health 128.5 (2014): 399-403.
- World Health Organization. WHO recommendations on interventions to improve preterm birth outcomes.
- Goldenberg RL and Culhane JF. “Low birth weight in the United States”. The American journal of clinical nutrition 85.2 (2007): 584S-90S.
- Behrman RE and Butler AS. Preterm birth: causes, consequences, and prevention.
- Johnson TJ., et al. “Economic benefits and costs of human milk feedings: a strategy to reduce the risk of prematurity-related morbidities in very-low-birth-weight infants”. Advances in nutrition 5.2 (2014): 207-12.
- Tucker J and McGuire W. “Epidemiology of preterm birth”. Bmj 329.7467 (2004): 675- 8.
- Purisch SE and Gyamfi-Bannerman C. “Epidemiology of preterm birth”. InSeminars in perinatology 41.7 (2017): 387-391.
- Cutland CL., et al. “Low birth weight: Case definition & guidelines for data collection, analysis, and presentation of maternal immunization safety data”. Vaccine 35.48 (2017): 6492-6500.
- Quinn JA., et al. “Preterm birth: Case definition & guidelines for data collection, analysis, and presentation of immunisation safety data”. Vaccine 34.49 (2016): 6047-56.
- McCarthy R., et al. “Mouse models of preterm birth: suggested assessment and reporting guidelines”. Biology of reproduction 99.5 (2018): 922-37.
- Seidel HM., et al. “Mosby's Guide to Physical Examination-E-Book”. Elsevier Health Sciences (2010).
- Tunon K., et al. “Gestational age in pregnancies conceived after in vitro fertilization: a comparison between age assessed from oocyte retrieval, crown‐rump length and biparietal diameter”. Ultrasound in Obstetrics and Gynecology 15.1 (2000): 41-6.
- Cech DJ and Martin ST. “Functional Movement Development Across the Life Span-E-Book”. Elsevier Health Sciences (2011).
- Adolph KE and Berger SE. “Motor development”. Handbook of child psychology 2 (2007): 39
- Cui LR., et al. “Physical and occupational therapy utilization in a pediatric intensive care unit”. Journal of critical care 40 (2017): 15-20.
- Marks K., et al. “The thorny nature of predictive validity studies on screening tests for developmental-behavioral problems”. Pediatrics 122.4 (2008): 866-8.
- Shapiro-Mendoza CK and Lackritz EM. “Epidemiology of late and moderate preterm birth”. InSeminars in Fetal and Neonatal Medicine 17.3 (2012): 120-125.
- Stoinska B and Gadzinowski J. “Neurological and developmental disabilities in ELBW and VLBW: follow-up at 2 years of age”. Journal of Perinatology 31.2 (2011): 137-42.
- Rebage V., et al. “Neurological newborn in our center and follow-up”. Revista de neurologia 47 (2008): S1-13.
- Newborn A. “Hospital discharge of the high-risk neonate”. Pediatrics 122.5 (2008): 1119-26.
- Amorim RC., et al. “Family health program: proposal to identify risk factors for neuropsychomotor development”. Brazilian Journal of Physical Therapy 13 (2009): 506-13.
- Kayenne Martins Roberto Formiga C, Linhares MB. “Motor development curve from 0 to 12 months in infants born preterm”. Acta Paediatrica 100.3 (2011): 379-84.
- Celik HI., et al. “Investigation of the relationship between sensory processing and motor development in preterm infants”. American Journal of Occupational Therapy 72.1 (2018): 7201195020p1-7.
- Malina RM. “Motor development during infancy and early childhood: Overview and suggested directions for research”. International journal of sport and health science 2 (2004): 50-66.
- Adolph KE and Berger SE. “Motor development”. Handbook of child psychology (2007).
- de Kieviet JF., et al. “Motor development in very preterm and very low-birth-weight children from birth to adolescence: a meta-analysis”. Jama 302.20 (2009): 2235-42.
- van Vliet EO., et al. “Perinatal infections and neurodevelopmental outcome in very preterm and very low-birth-weight infants: a metaanalysis”. JAMA pediatrics 167.7 (2013): 662-8.
- Wallois F, Routier L and Bourel-Ponchel E. “Impact of prematurity on neurodevelopment”. InHandbook of clinical neurology 173 (2020): 341-375.
- Walhovd KB., et al. “Long-term influence of normal variation in neonatal characteristics on human brain development”. Proceedings of the National Academy of Sciences 109.49 (2012): 20089-94.
- Valentini NC., et al. “Motor trajectories of preterm and full‐term infants in the first year of life”. Pediatrics International 61.10 (2019): 967-77.
- YH Jeng SF., et al. “Gross motor trajectories during the first year of life for preterm infants with very low birth weight”. Physical therapy 97.3 (2017): 365-73.
- Piper MC., et al. “Construction and validation of the Alberta Infant Motor Scale (AIMS)”. Canadian journal of public health= Revue canadienne de sante publique 83 (1992): S46-50.
- Jeng SF., et al. “Alberta infant motor scale: reliability and validity when used on preterm infants in Taiwan”. Physical therapy 80.2 (2000): 168-78.
- Restiffe AP and Gherpelli JL. “Comparison of chronological and corrected ages in the gross motor assessment of low-risk preterm infants during the first year of life”. Arquivos de neuro-psiquiatria 64 (2006): 418-25.
- Van Haastert IC., et al. “Gross motor functional abilities in preterm‐born children with cerebral palsy due to periventricular leukomalacia”. Developmental Medicine & Child Neurology 50.9 (2008): 684-9.
- De Kieviet JF., et al. “Motor development in very preterm and very low-birth-weight children from birth to adolescence: a meta-analysis”. Jama 302.20 (2009): 2235-42.
- Månsson J, Fellman V and Stjernqvist K. Express Study Group (authors). “Extremely preterm birth affects boys more and socio‐economic and neonatal variables pose sex‐ specific risks”. Acta paediatric 104.5 (2015): 514-21.
- Inder TE., et al. “Defining the nature of the cerebral abnormalities in the premature infant: a qualitative magnetic resonance imaging study”. The Journal of pediatrics 143.2 (2003): 171-9.
- Goyen TA., et al. “Eye–hand coordination skills in very preterm infants< 29 weeks gestation at 3 years: effects of preterm birth and retinopathy of prematurity”. Early human development 82.11 (2006): 739-45.
- O’Shea TM., et al. “Intraventricular hemorrhage and developmental outcomes at 24 months of age in extremely preterm infants”. Journal of child neurology 27.1 (2012): 22-9.
- Beligere N., et al. “Neurodevelopmental Disabilities in Children with Retinopathy of Prematurity: A Report from India”. Int J Ophthalmol Clin Res 7 (2020): 114.
- Stylianou-Riga P., et al. “Maternal socioeconomic factors and the risk of premature birth and low birth weight in Cyprus: a case–control study”. Reproductive health 15.1 (2018): 157.
- Kepenek-Varol B., et al. “Assessment of motor development using the Alberta Infant Motor Scale in full-term infants”. Turk J Pediatr 62.1 (2020): 94-102.