Difficult birth and motor outcome in early infancy and at school age
It is well known that children born with a serious deprivation of oxygen (asphyxia) at birth are at high risk for developmental problems. In this thesis we assessed the sequelae of moderate to mild asphyxia in term infants at the age of 6 years. We labelled this condition Difficult Birth At Term (DBAT). Children with DBAT are mostly admitted to regional hospitals that lack the sophisticated imaging techniques of academic centres. This was the context of the study.
Two groups of children were followed: 64 infants with DBAT and 81 control infants. During the first weeks after birth we assessed their ‘General Movements (GMs)’. GMs are movements involving the whole body, present up until 4 months of age. The degree of variation of GMs is a marker of the health of the nervous system. GM-quality is a good predictor of developmental outcome in preterm infants and infants with serious problems around birth. At the age of six years all children were examined with a battery of tests with special attention to motor abilities.
The study showed that: 1) children with milder forms of DBAT resulting in neurological signs at birth are at increased risk for developmental problems at age 6, especially for impaired manual abilities; 2) GM-quality does predict outcome in term infants without major problems at birth, but with less power than in preterm infants.
We advise to routinely monitor development in all infants with DBAT accompanied by neurological symptoms, starting with GMs in the first months of life.