Predicting severe motor impairment in preterm children at age 5 years

Anne Synnes, Peter J. Anderson, Ruth E. Grunau, Deborah Dewey, Diane Moddemann, Win Tin, Peter G. Davis, Lex W. Doyle, Gary Foster, May Khairy, Chukwuma Nwaesei, Barbara Schmidt, Judy D'Ilario, Janice Cairnie, Joanne Dix, Beth Anne Adams, Erin Warriner, Mee Hai Marie Kim, Brenda Argus, Catherine CallananNoni Davis, Julianne Duff, Marion McDonald, Elizabeth Asztalos, Denise Hohn, Maralyn Lacy, Ross Haslam, Christopher Barnett, Louise Goodchild, Rosslyn Marie Lontis, Simon Fraser, Julie Keng, Kerryn Saunders, Gillian Opie, Elaine Kelly, Heather Woods, Emma Marchant, Anne Marie Turner, Emma Magrath, Amanda Williamson, Aida Bairam, Sylvie Bélanger, Annie Fraser, Marc Blayney, Brigitte Lemyre, Jane Frank, Alfonso Solimano, Philippa Hubber-Richard, Marilyn Rogers, Margot Mackay, Julianne Petrie-Thomas, Arsalan Butt, Aleid Van Wassenaer, Debbie Nuytemans, Bregje Houtzager, Loekie Van Sonderen, Rivka Regev, Netter Itzchack, Shmuel Arnon, Adiba Chalaf, Arne Ohlsson, Karel O'Brien, Anne Marie Hamilton, May Lee Chan, Koravangattu Sankaran, Pat Proctor, Agneta Golan, Esther Goldsch-Lerman, Graham Reynolds, Barbara Dromgool, Andra Meskell, Vanessa Parr, Catherine Maher, Margaret Broom, Zsuzsoka Kecskes, Cathy Ringland, Douglas McMillan, Elizabeth Spellen, Reginald S. Sauve, Heather Christianson, Deborah Anseeuw-Deeks, Dianne Creighton, Jennifer Heath, Ruben Alvaro, Aaron Chiu, Ceceile Porter, Gloria Turner, Naomi Granke, Karen Penner, Jane Bow, Antonius Mulder, Renske Wassenberg, Markus Van Der Hoeven, Maxine Clarke, Judy Parfitt, Kevin Parker, Heather Ryan, Cory Saunders, Andreas Schulze, Inga Wermuth, Anne Hilgendorff, Andreas W. Flemmer, Eric Herlenius, Lena Legnevall, Hugo Lagercrantz, Derek Matthew, Wendy Amos, Suresh Tulsiani, Cherrie Tan-Dy, Marilyn Turner, Constance Phelan, Eric S. Shinwell, Michael Levine, Ada Juster-Reicher, Patricia Grier, Julie Vachon, Larissa Perepolkin, Keith J. Barrington, Sunil Kumar Sinha, Susan Fritz, Herve Walti, Diane Royer, Henry Halliday, David Millar, Clifford Mayes, Christopher McCusker, Olivia McLaughlin, Hubert Fahnenstich, Bettina Tillmann, Peter Weber, Unni Wariyar, Nicholas Embleton, Ravi Swamy, Hans U. Bucher, Jean Claude Fauchere, Vera Dietz, Chidambara Harikumar

Research output: Contribution to journalArticlepeer-review

Abstract

Objective To determine whether the ability to predict severe motor impairment at age 5 years improves between birth and 18 months. Design Ancillary study of the Caffeine for Apnea of Prematurity Trial. Setting and Patients International cohort of very low birth weight children who were assessed sequentially from birth to 5 years. Outcome Measures Severe motor impairment was defined as a score <5th percentile on the Movement Assessment Battery of Children (MABC), or inability to complete the MABC because of cerebral palsy. Multivariable logistic regression cumulative risk models used four sets of predictor variables: early neonatal risk factors, risk factors at 36 weeks' postmenstrual age, risk factors at a corrected age of 18 months, and sociodemographic variables. A receiver operating characteristic curve (ROC) was generated for each model, and the four ROC curves were compared to determine if the addition of the new set of predictors significantly increased the area under the curve (AUC). Results Of 1469 children, 291 (19.8%) had a severe motor impairment at 5 years. The AUC increased from 0.650 soon after birth, to 0.718 (p<0.001) at 36 weeks' postmenstrual age, and to 0.797 at 18 months ( p<0.001). Sociodemographic variables did not significantly improve the AUC (AUC=0.806; p=0.07). Conclusions Prediction of severe motor impairment at 5 years of age using a cumulative risk model improves significantly from birth to 18 months of age in children with birth weights between 500 g and 1250 g.

Original languageEnglish
Pages (from-to)748-753
Number of pages6
JournalArchives of Disease in Childhood
Volume100
Issue number8
DOIs
StatePublished - 1 Aug 2015
Externally publishedYes

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