Page 172 - HA Convention 2015

Service Priorities and Programmes Free Papers

SPP5.2 Healthcare Advances, Research and Innovations 09:00 Room 221

Two-year Gross Motor Outcome of Very Low Birth Weight infants
Ho YB 1, Cheung MW 1, Chan ML1, Lee WY 1, Shek CC 2
1Physiotherapy Department, 2Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong

Introduction

Very low birth weight (VLBW, under 1,500g) infants are more susceptible to neuromotor problems and delayed motor
development.

Objectives

(1) To assess the gross motor (GM) developmental outcomes of VLBW infants at 18 months (m) (corrected age) and 24m
(chronological age); and (2) to investigate how well GM assessments at four and eight months to predict GM outcomes at
24m.

Tuesday, 19 May Methodology

A total of 144 VLBW infants (gestation 29.8±2.6 week, BW 1120±257g) born in 2010 or 2011 and discharged to the High Risk
Infant Programme of the Princess Margaret Hospital were followed up by physiotherapists at four, eight, 12 and 18m (corrected
age) and 24m (chronological age). The Infant Neurological International Battery (INFANIB) and Alberta Infant Movement Scale
(AIMS) were used to assess neuromotor and GM development, respectively, at four, eight and 12m. Peabody Developmental
Motor Scale (PDMS) was used to assess GM outcomes at 18 and 24m.

Results

During the follow-up period, five children (3.5%) were found to have major disabilities, including cerebral palsy (2, 1.4%),
severe hearing impairments (3, 2%), ataxia (1, 0.7%) and total blindness (1, 0.7%). 38 (26.4%) children had received different
durations of physiotherapy intervention due to impaired or delayed motor performance. Of 100 (69% of 144) children
assessed at 18m corrected age, 63% were normal, 11% were below average (DMQ 70-89) and 26% were poor (DMQ<70) on
PDMS. Of 77 (53% of 144) children assessed at 24m chronological age, 33%, 4% and 64% had normal, below average and
poor GM performance, respectively. Chi-square tests showed that 83.6% of infants with a normal AIMS score at four months
corrected age had normal PDMS result (DMQ≥70 ) at 18m corrected age (p<0.001). On the other hand 92.3% of infants
showing abnormal or suspicious AIMS score (≤16th percentile) at eight months corrected age had poor PDMS score at 24m
chronological age (p=0.02). Logistic regression showed that infants with abnormal or suspicious AIMS results at four months
corrected age were 6.6 times (95% CI 2.4-18.5, p<0.001) as likely to have abnormal PDMS result at 18m corrected age .
Infants with abnormal or suspicious AIMS results at eight months corrected age were 8.6 times (95% CI 1.1-70.3, p=0.045) as
likely to have abnormal PDMS results at 24m chronological age.

Conclusion

Our study suggested that abnormal or suspicious AIMS scores at eight months corrected age predicted poor GM outcomes
at 24m chronological age. Since most of the VLBW infants did not catch up with their GM development at 24m chronological
age, we would suggest assessing the infants at 24m corrected age instead. Moreover there is also a service need to extend
the follow-up period especially for those with poor performance.

HOSPITAL AUTHORITY CONVENTION 2015

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