Longitudinal motor development of "apparently normal" high-risk infants at 18 months, 3 and 5 years.

BACKGROUND Motor development appears to be more affected by premature birth than other developmental domains, however few studies have specifically investigated the development of gross and fine motor skills in this population. AIM To examine longitudinal motor development in a group of "apparently normal" high-risk infants. SETTING Developmental follow-up clinic in a perinatal centre. STUDY DESIGN Longitudinal observational cohort study. SUBJECTS Fifty-eight infants born less than 29 weeks gestation and/or 1000 g and without disabilities detected at 12 months. OUTCOME MEASURES Longitudinal gross and fine motor skills at 18 months, 3 and 5 years using the Peabody Developmental Motor Scales. The HOME scale provided information of the home environment as a stimulus for development. RESULTS A large proportion (54% at 18 months, 47% at 3 years and 64% at 5 years) of children continued to have fine motor deficits from 18 months to 5 years. The proportion of infants with gross motor deficits significantly increased over this period (14%, 33% and 81%, p<0.001), particularly for the 'micropreemies' (born <750 g). In multivariate analyses, gross motor development was positively influenced by the quality of the home environment. CONCLUSIONS A large proportion of high-risk infants continued to have fine motor deficits, reflecting an underlying problem with fine motor skills. The proportion of infants with gross motor deficits significantly increased, as test demands became more challenging. In addition, the development of gross and fine motor skills appears to be influenced differently by the home environment.