ABSTRACT
Introduction: To determine whether chronic lung disease (CLD) influences specific aspects of motor development in infancy. Materials and Methods: Twenty-nine very low birthweight infants with CLD at 36 weeks’ post-conceptional age and 31 infants without CLD were evaluated at 8 months’ and 24 months’ corrected age using the Neurosensory Motor Development Assessment. Perinatal and neonatal characteristics of the infants with CLD and control infants were compared using the chi-square test for categorical variables and Student’s t-test for continuous variables. The relationship between CLD and adverse outcome was measured by the odds ratio (OR) and its 95% confidence interval (CI). Results: The overall developmental scores of the CLD infants were significantly different compared with control infants at 8 months. By 2 years of age, both groups of infants showed marked improvement in motor performance. However, differences persisted in the area of postural balance and sensory motor skills. Taking periventricular haemorrhage and periventricular leukomalacia into consideration, CLD contributed significantly to the occurrence of motor dysfunction at 8 months of age [odds ratio (OR), 7.4; 95% confidence interval (CI), 2.1 to 26.5]. The impact of CLD on motor development remained substantial, though not statistically significant (OR, 3.7; 95% CI, 0.4 to 37.9) at 2 years of age. Conclusion: CLD has a definite effect on motor development. The pathologic influence of CLD on motor development remains speculative but results of this study emphasise the need for careful neurodevelopmental follow-up of infants with CLD, whether or not these infants suffer intraventricular haemorrhage or periventricular leukomalacia.
New approaches in obstetric management of preterm births as well as the increased availability of tertiary neonatal care have resulted in improved survival rates of very low birthweight infants. The decline in mortality of these high-risk infants has been accompanied by an increase in the absolute number of infants with chronic lung disease (CLD). The incidence of neurological sequelae in infants with CLD was recently reported to be much higher than that of infants without CLD (40% compared with 6% respectively).1 Impaired development in infants with CLD was linked to intraventricular haemorrhage and/or periventricular leukomalacia, rather than the lung disease per se.2-5 Singer et al6 showed that CLD had an unfavourable effect on motor performance at 3 years of age, and neurological risk factors and social class had a negative effect on mental development. Katz-Salamon et al7 reported poorer eye-hand coordination and proprioception amongst infants with CLD at 5 months and 10 months of age. Reports on the pattern of neurodevelopmental and motor performance difficulties in these infants were limited.
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