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

Aim:To assess the predictive validity of parent reported gross motor impairment (GMI) at age twoyears to detect significant movement difficulties (MD) at age five in children born extremely preterm.Method:  Data come from 556 children born <28 weeks’ gestation in 2011-12 in 10 Europeancountries. Parent report of moderate/severe GMI was defined as walking unsteadily or unable towalk unassisted at two years corrected age. Examiners assessed significant MD (score ≤5th percentileon the Movement Assessment Battery for Children, 2nd Edition) and diagnoses of cerebral palsy (CP)were collected via parent report at five years chronological age. Results:At two years, 66 (11.9%) children had moderate/severe GMI. At five years, 212 (38.1%) hadsignificant MD. Parent reports of GMI at age two accurately classified CP at age five in 91.0-93.2% ofchildren. Classification of moderate/severe GMI at age two had high specificity (96.2%; 95% CI 93.6%,98.0%) and positive predictive value (80.3%; 68.7%, 89.1%) for significant MD at age five. However,74.5% of children with significant MD at five years were not identified with moderate/severe GMI atage two, resulting in low sensitivity (25.1%; 19.4%, 31.5%). Interpretation: This questionnaire may be used to identify extremely preterm children at age twowho have a diagnosis of CP or MD that are likely to have a significant impact on their functionaloutcomes at age five.