Prediction of movement difficulties at age five from parent report at age two in children born extremely preterm

<p>Aim</p> <p>To assess the predictive validity of parent-reported gross motor impairment (GMI) at age 2 years to detect significant movement difficulties at age 5 years in children born extremely preterm.</p> <p><br></p> <p>Method</p> <p>Data were from 556 children (270 males, 286 females) born at less than 28 weeks' gestation in 2011 to 2012 in 10 European countries. Parent report of moderate/severe GMI was defined as walking unsteadily or unable to walk unassisted at 2 years corrected age. Examiners assessed significant movement difficulties (score ≤ 5th centile on the Movement Assessment Battery for Children, Second Edition) and diagnoses of cerebral palsy (CP) were collected by parent report at 5 years chronological age.</p> <p><br></p> <p>Results</p> <p>At 2 years, 66 (11.9%) children had moderate/severe GMI. At 5 years, 212 (38.1%) had significant movement difficulties. Parent reports of GMI at age 2 years accurately classified CP at age 5 years in 91.0% to 93.2% of children. Classification of moderate/severe GMI at age 2 years had high specificity (96.2%; 95% confidence interval 93.6–98.0) and positive predictive value (80.3%; 68.7–89.1) for significant movement difficulties at age 5 years. However, 74.5% of children with significant movement difficulties at 5 years were not identified with moderate/severe GMI at age 2 years, resulting in low sensitivity (25.1%; 19.4–31.5).</p> <p><br></p> <p>Interpretation</p> <p>This questionnaire may be used to identify children born extremely preterm who at age 2 years have a diagnosis of CP or movement difficulties that are likely to have a significant impact on their functional outcomes at age 5 years.</p> <p><br></p> <p>Graphical Abstract</p> <p>Parent reported motor impairment at age 2 years accurately classified movement difficulties at age 5 years in 68% to 69% of children. Specificity was very high for predicting motor function in the average range at age 5 years from parent report of no moderate/severe gross motor impairment (GMI) at age 2 years. Positive predictive value was also high, indicating that about 80% of children with moderate/severe GMI at age 2 years had significant movement difficulties at age 5 years. However, sensitivity was relatively low, which resulted in under-identification of children at age 2 years who had significant movement difficulties at age 5 years.</p>