Motor-related health care for 5-year-old children born extremely preterm with movement impairments
Costa R., Aubert AM., Seppänen AV., Ådén U., Sarrechia L., Zemlin M., Cuttini M., Männamaa M., Pierrat V., van Heijst A., Barros H., Johnson S., Zeitlin J., Lebeer J., Van Reempts P., Bruneel E., Cloet E., Oostra A., Ortibus E., Boerch K., Pedersen P., Toome L., Varendi H., Ancel PY., Burguet A., Jarreau PH., Nuytten A., Truffert P., Maier RF., Misselwitz B., Wohlers L., Croci I., Carnielli V., Ancora G., Faldella G., Ferrari F., Koopman-Esseboom C., Gadzinowski J., Mazela J., Montgomery A., Pikuła T., Rodrigues C., Draper ES., Fenton A., Mader S., Thiele N., Pfeil JM., Petrou S., Kim SW., Andronis L., Bonnet C., El Rafei R.
Aim: To (1) determine the proportion of 5-year-old children born extremely preterm (EPT) with movement difficulties including cerebral palsy (CP) and the proportion of these children receiving motor-related health care (MRHC), and (2) describe factors associated with receiving MRHC. Method: Children born before 28 weeks’ gestation in 2011 to 2012 in 11 European countries were assessed with the Movement Assessment Battery for Children, Second Edition (MABC-2) at 5 years of age. Information on family characteristics, child health including CP diagnosis, and health care use were collected using parent-report questionnaires. MRHC was defined as visits in the previous year with health care providers (physical and occupational therapists) specialized in assessing/treating motor problems. We analysed receipt of MRHC and associated factors among children at risk of movement difficulties (MABC-2 score 6th–15th centiles), with significant movement difficulties (SMD; ≤5th centile) or with CP. Results: Of 807 children assessed at 5 years 7 months (SD 4 months; 4 years 7 months–7 years 1 month), 412 were males (51.1%), 170 (21.1%) were at risk of movement difficulties, 201 (24.9%) had SMD, and 92 (11.4%) had CP. Those who received MRHC comprised 89.1% of children with CP, 42.8% with SMD, and 25.9% at risk of movement difficulties. MRHC for children with SMD varied from 23.3% to 66.7% between countries. Children were more likely to receive MRHC if they had other developmental problems or socioemotional, conduct, or attention difficulties. Interpretation: Efforts are needed to increase MRHC for 5-year-old children born EPT with movement difficulties. What this paper adds: Children born extremely preterm without cerebral palsy frequently experienced motor difficulties. Most of these children were not receiving motor-related health care (MRHC). Large geographical differences throughout Europe were observed in receipt of MRHC. Socioemotional problems were related to MRHC use.