March 22, 2018 / 3:53 PM / 6 months ago

More preemies developing motor impairments

(Reuters Health) - More than one-third of extremely premature and underweight babies have cerebral palsy or other motor impairments that can make it hard for them to do basic things like ride a bike or use a fork, an Australian study suggests.

Researchers examined data on children in Victoria, Australia, who were born at less than 28 weeks gestation or weighing less than 1,000 grams (2.2 pounds) during three time periods: 1991-1992, 1997 and 2005.

The proportion of these vulnerable babies who had cerebral palsy or other motor impairments by age 8 climbed from 23 percent at the start of the study to 37 percent by the end.

While the study wasn’t designed to assess why this is happening, it’s possible that children born with developmental deficits today have fewer opportunities to move around and stimulate their brains to help improve their motor skills, said lead study author Alicia Spittle, of the University of Melbourne and the Murdoch Children’s Research Institute in Australia.

“It could be that with increases in technology and screen time, along with less children actively commuting to school (e.g. walking, biking) that children are getting less active and this is affecting their overall motor skills,” Spittle said by email.

Pregnancy normally lasts about 40 weeks, and babies born after 37 weeks are considered full term.

In the weeks immediately after birth, preemies often have difficulty breathing and digesting food. They can also encounter longer-term challenges such as impaired vision, hearing and cognitive skills, as well as social and behavioral problems.

For the current study, researchers focused on almost 1,200 extremely preterm or underweight infants who were born without lethal abnormalities.

The proportion of these vulnerable babies who survived to age 8 increased from 54 percent at the start of the study to 64 percent by the end, aided by advances in medical technology, researchers report in Pediatrics.

However, motor impairments also became more common over time in a comparison group of full-term babies in the study, accounting for 2 percent of babies initially and rising to 7 percent by the end. That suggests the increase in motor impairments among extreme preemies is not a result of better survival in the more recent periods.

One limitation of the study is that medical definitions of motor impairments have changed over time, and this may explain at least some of the increase in the proportion of children considered to have these types of developmental issues, the authors note.

“The apparent increase in the risk of motor impairments in very premature babies over time is an important finding, although this could be due to the change in the methods used to measure the outcome,” said Ali Khashan of the School of Public Health and INFANT Research Centre at the University College Cork in Ireland.

Still, parents of preemies should be on the lookout for early signs of motor delays, Khashan said by email.

Even when kids don’t have cerebral palsy, other less severe motor impairments can still be quite serious and contribute to learning disabilities, behavior problems and challenges with basic skills like eating or participating in sports, said Dr. Aijaz Farooqi, medical director of regional neonatal intensive care at Umea University Hospital in Sweden.

“Motor impairments without cerebral palsy are common in early-school age in children born extremely preterm or extremely low birth weight,” Farooqi, who wasn’t involved in the study, said by email. “Interventions that might be effective can be started very early in the neonatal intensive care unit (NICU) or nursery, and when possible skin-to skin care is beneficial for both parents and infants.”

After babies leave the hospital, parents can support development by encouraging movement and play with other kids, as well as by reading and speaking to them often, Farooqi advised. As they approach school age, occupational and physical therapy may also help.

SOURCE: bit.ly/2px1BAk Pediatrics, online March 22, 2018.

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