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Motor challenges were prevalent in extremely preterm children, regardless of early brain imaging results, underscoring the need for ongoing developmental support.   

Researchers conducted a retrospective study published in June 2025 issue of Journal of Pediatrics to evaluate initial and late cranial ultrasound (CUS) and near-term brain MRI findings, including white matter abnormalities (WMA), as indicators of motor coordination impairment at school age in children born extremely preterm (EPT).  

They assessed infants born between 24 and 27+6/7 weeks with estimated gestational age (EGA) as part of the Surfactant Positive Airway Pressure and Pulse Oximetry Trial (SUPPORT). Neonatal CUS and near-term conventional MRIs were assessed to predict outcomes. At 6 to 7 years, motor function was evaluated using the Movement Assessment Battery for Children (MABC-2), with significant motor impairment defined as a total test score below the 5th percentile. Logistic regression analysis was used to examine associations with near-term neuroimaging, adjusting for perinatal and neonatal variables.  

The results showed that MABC-2 total test scores were available for 320 individuals. Significant motor impairment was observed in nearly one-third with prevalence increasing as EGA decreased: 41% at 24 weeks, 41% at 25 weeks, 31% at 26 weeks, and 21% at 27 weeks. Higher impairment rates were linked to adverse late CUS findings and greater severity of WMA. However, impairment also occurred in 29% with normal late CUS and 22% without WMA on MRI. In the overall group, motor impairment was independently associated with adverse late CUS (aOR 5.0, 95% CI 1.5–16.3) and among those without cerebral palsy, with moderate to severe WMA (aOR 2.3, 95% CI 1.1–4.9).  

Investigators concluded that motor coordination impairment occurred frequently among EPT infants regardless of neonatal neuroimaging findings.   

Source: jpeds.com/article/S0022-3476(25)00245-8/abstract