title: Movement outcomes of infants born moderate and late preterm.
abstract: OBJECTIVE
  To investigate whether children born between 32 and 36 weeks of gestation have an increased risk of motor coordination difficulties or cerebral palsy (CP) at age 7 years.
  
  
  METHODS
  A cohort study based on the Avon Longitudinal Study of Parents and Children (ALSPAC). The primary outcomes were poor motor coordination, defined as an ALSPAC coordination test score <5th centile or the presence of CP. Exposure groups were defined as moderate or late preterm (32-36 weeks of gestation) or term (37-42 weeks). Regression models were used to investigate the association between gestational age and outcomes. Multiple imputation was used to account for missing covariate data.
  
  
  RESULTS
  In the fully adjusted model, there was strong evidence that children born at moderate or late preterm had worse coordination (OR 1.41 (1.14-1.74)) and higher risk of CP (OR 6.38 (2.28-17.76)) than term peers. However, restricting the analysis to well-grown infants born vaginally, in good condition, the associations attenuated substantially.
  
  
  CONCLUSIONS
  Moderate or late preterm infants were at increased risk of developing coordination problems and cerebral palsy. After restricting the analysis to 'well' infants the associations of gestation with the coordination measures and CP reduced substantially, suggesting that antenatal, intrapartum and neonatal causal pathways are likely to be involved.
authors.affiliation: Neonatal Unit, Southmead Hospital, Bristol, UK; Clinical Science at North Bristol, University of Bristol, Bristol, UK. david.odd@bristol.ac.uk
authors.forename: David Edward
authors.initials: DE
authors.lastname: Odd
authors.forename: Raghu
authors.initials: R
authors.lastname: Lingam
authors.forename: Alan
authors.initials: A
authors.lastname: Emond
authors.forename: Andrew
authors.initials: A
authors.lastname: Whitelaw
mesh_terms: D017677:Age Distribution; D000704:Analysis of Variance; D002547:Cerebral Palsy / Q000175:diagnosis* / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008137:Longitudinal Studies; D008297:Male; D019957:Motor Skills Disorders / Q000175:diagnosis / Q000453:epidemiology*; D016017:Odds Ratio; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution
keywords: Avon longitudinal study of parents and children; Cerebral palsy; Cohort studies; Premature infants