TOPLINE:

Children born extremely preterm without cerebral palsy (CP) or severe neurodevelopmental impairments (NDIs) had substantially higher rates of motor difficulties at 12 years than their peers born at term, with male sex and lower gestational age (GA) being independent predictors. These children were more likely to have autism spectrum and attention-deficit/hyperactivity disorders.

METHODOLOGY:

• Researchers analysed data from a prospective population-based cohort study in Sweden to determine the prevalence of significant non-CP motor difficulties at 12 years of age in children born extremely preterm (< 27 weeks of GA) between April 2004 and March 2007 and to identify associated risk factors and comorbidities.
• A total of 268 children born extremely preterm without CP or severe NDIs (mean GA, 25.0 weeks; 139 boys) were matched with 196 healthy children born at term (mean GA, 39.5 weeks; 112 boys) from the Swedish birth registry, all of whom completed motor assessments at 12 years.
• Motor function was evaluated at 12 years using the Movement Assessment Battery for Children-Second Edition (MABC-2), a standardised tool comprising eight items across three domains: manual dexterity, ball skills, and balance skills. Significant motor difficulties were defined as an overall MABC-2 score at or below the fifth percentile.

TAKEAWAY:

• At 12 years of age, children born extremely preterm had a higher prevalence of overall motor difficulties than those born at term (30% vs 3%; adjusted odds ratio [aOR], 16.99; P < .0001); greater impairment was observed across all MABC-2 domains, with the highest risk observed for balance skills (aOR, 26.38; P < .0001).
• Among children born extremely preterm, male sex (aOR, 1.95; P = .02) and lower GA (aOR for every week decrease, 2.02; P < .0001) were independently associated with significant motor difficulties.
• Children born extremely preterm with motor difficulties had more frequent autism spectrum disorder (23% vs 5%) and attention-deficit/hyperactivity disorder (37% vs 13%) than those without motor difficulties (P < .0001 for both).
• Only 30%-37% of the parents of children born extremely preterm reported that their child had gross and/or fine motor problems, and just 9.5% of affected children had received recent physiotherapy.

IN PRACTICE:

"Our study highlights the importance of performing repeated assessment of motor function for high-risk children, throughout childhood and beyond the present national follow-up programmes, into mid-school age, so that children in need of intervention are not missed," the authors wrote.

SOURCE:

This study was led by Maria Örtqvist, Karolinska Institutet, Stockholm, Sweden. It was published online on May 08, 2026, in Archives of Disease in Childhood.

LIMITATIONS:

The study used a non-validated parental questionnaire to assess motor-related healthcare utilisation, which may have led to underreporting and made the interpretation of low physiotherapy use more difficult. Limited questionnaire items prevented the evaluation of reliability measures. Cross-sectional analysis at 12 years did not capture longitudinal motor development trajectories.

DISCLOSURES:

This study was supported by grants from the Swedish Research Council, Swedish Brain Foundation, Region Stockholm for clinical research appointments, and others. The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.