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Hand Function at 18-22 Months Is Associated with School-Age Manual Dexterity and Motor Performance in Children Born Extremely Preterm.

CPQCC Publication
TitleHand Function at 18-22 Months Is Associated with School-Age Manual Dexterity and Motor Performance in Children Born Extremely Preterm.
Publication TypeJournal Article
Year of Publication2020
AuthorsDuncan AF, Bann CM, Maitre NL, Peralta-Carcelen M, Hintz SR
Corporate AuthorsEunice Kennedy Shriver National Institute of Child Health and Development Neonatal Research Network
JournalJ Pediatr
Volume225
Pagination51-57.e3
Date Published2020 10
ISSN1097-6833
KeywordsChild, Educational Status, Female, Hand, Humans, Infant, Infant, Extremely Premature, Infant, Newborn, Linear Models, Longitudinal Studies, Male, Motor Skills, Movement, Prospective Studies, Psychomotor Performance, Regression Analysis
Abstract

OBJECTIVES: To determine associations between hand function at age 18-22 months (early) and scores on the Movement Assessment Battery for Children, 2nd edition (MABC) at 6-7 years of age (school age) in extremely preterm children.

STUDY DESIGN: Prospective multicenter cohort of 313 extremely preterm children with early hand function assessment and school-age MABC testing. Early hand function was compared with "definite deficits" (MABC <5th percentile) and MABC standard scores. Early hand function was categorized as "no deficit" vs "any deficit." Mixed-effects regression models were used to evaluate the association of early hand function with MABC deficits, controlling for multiple demographic, neonatal, and childhood factors.

RESULTS: Children with early hand function deficits were more likely to have definite school-age deficits in all MABC subtests (Manual Dexterity, Aiming and Catching, and Balance) and to have received physical or occupational therapy (45% vs 26%; P < .001). Children with early hand function deficits had lower Manual Dexterity (P = .006), Balance (P = .035), and Total Test (P = .039) scores. Controlling for confounders, children with early hand function deficits had higher odds of definite school-age deficits in Manual Dexterity (aOR, 2.78; 95% CI, 1.36-5.68; P = .005) and lower Manual Dexterity (P = .031) and Balance (P = .027) scores. When excluding children with cerebral palsy and those with an IQ <70, hand function deficits remained significantly associated with manual dexterity.

CONCLUSION: Hand function deficits at age 18-22 months are associated with manual dexterity deficits and motor difficulties at school age, independent of perinatal-neonatal factors and the use of occupational or physical therapy. This has significant implications for school success, intervention, and rehabilitative therapy development.

DOI10.1016/j.jpeds.2020.05.048
Alternate JournalJ Pediatr
PubMed ID32474029
PubMed Central IDPMC7652574
Grant ListU10 HD021385 / HD / NICHD NIH HHS / United States
U10 HD053124 / HD / NICHD NIH HHS / United States
U10 HD053119 / HD / NICHD NIH HHS / United States
U10 HD021364 / HD / NICHD NIH HHS / United States
U10 HD040461 / HD / NICHD NIH HHS / United States
U10 HD027904 / HD / NICHD NIH HHS / United States
UL1 RR025744 / RR / NCRR NIH HHS / United States
U10 HD027851 / HD / NICHD NIH HHS / United States
UL1 RR025008 / RR / NCRR NIH HHS / United States
U24 HD095254 / HD / NICHD NIH HHS / United States
U10 HD053089 / HD / NICHD NIH HHS / United States
U10 HD027856 / HD / NICHD NIH HHS / United States
U10 HD021373 / HD / NICHD NIH HHS / United States
U10 HD027880 / HD / NICHD NIH HHS / United States
U10 HD053109 / HD / NICHD NIH HHS / United States
U10 HD040689 / HD / NICHD NIH HHS / United States
U10 HD040492 / HD / NICHD NIH HHS / United States
U10 HD034216 / HD / NICHD NIH HHS / United States
U10 HD036790 / HD / NICHD NIH HHS / United States