Preterm birth and developmental problems in the preschool age. Part I: minor motor problems

Fabrizio Ferrari, Claudio Gallo, Marisa Pugliese, Isotta Guidotti, Sara Gavioli, Elena Coccolini, Paola Zagni, Elisa Della Casa, Cecilia Rossi, Licia Lugli, Alessandra Todeschini, Luca Ori, Natascia Bertoncelli
Journal of Maternal-fetal & Neonatal Medicine 2012, 25 (11): 2154-9
Nearly half of very preterm (VP) and extremely preterm (EP) infants suffers from minor disabilities. The paper overviews the literature dealing with motor problems other than cerebral palsy (CP) during infancy and preschool age. The term "minor motor problems" indicates a wide spectrum of motor disorders other than CP; "minor" does not mean "minimal", as a relevant proportion of the preterm infants will develop academic and behavioural problems at school age. Early onset disorders consist of abnormal general movements (GMs), transient dystonia and postural instability; these conditions usually fade during the first months. They were underestimated in the past; recently, qualitative assessment of GMs using Prechtl's method has become a major item of the neurological examination. Late onset disorders include developmental coordination disorder (DCD) and/or minor neurological dysfunction (MND): both terms cover partly overlapping problems. Simple MND (MND-1) and complex MND (MND-2) can be identified and MND-2 gives a higher risk for learning and behavioural disorders. A relationship between the quality of GMs and MND in childhood has been recently described. The Touwen infant neurological examination (TINE) can reliably detect neurological signs of MND even in infancy. However, the prognostic value of these disorders requires further investigations.

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