4.5 Article

Motor performance and cognitive correlates in children cooled for neonatal encephalopathy without cerebral palsy at school age

Journal

ACTA PAEDIATRICA
Volume 108, Issue 10, Pages 1773-1780

Publisher

WILEY
DOI: 10.1111/apa.14780

Keywords

Bayley-III; MABC-2; Neonatal encephalopathy; Therapeutic hypothermia; WISC-IV

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Funding

  1. Baily Thomas Charitable Fund, Luton, UK
  2. David Telling Charitable Trust, University Hospitals Bristol NHS Trust, Bristol, UK
  3. Moulton Foundation, London, UK
  4. SPARKS, London, UK

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Aim: To investigate whether motor performance in school-age children without cerebral palsy (CP), cooled for neonatal encephalopathy, is associated with perinatal factors and 18-month developmental scores and to explore relationships between school-age motor and cognitive performance. Methods: Motor and cognitive performance was assessed in 29 previously cooled children at six to eight years using the Movement Assessment Battery for Children-2 (MABC-2) and the Wechsler Intelligence Scale for Children (WISC-IV). Associations between MABC-2 scores less than/equal (<=) 15th centile and perinatal factors, social/family background, 18-month Bayley-III scores and WISC-IV scores were explored. Results: Eleven of the 29 (38%) children had MABC-2 scores <= 15th centile including 7 (24%) <= 5th centile. No significant perinatal or socio-economic risk factors were identified. Motor scores <85 at 18 months failed to identify children with MABC-2 scores <= 15th centile. MABC-2 scores <= 15th centile were associated with lower Full Scale IQ (p = 0.045), Working Memory (p = 0.03) and Perceptual Reasoning (p = 0.005) scores at six to eight years and receiving greater support in school (p = 0.01). Conclusion: A third of cooled children without CP had MABC-2 scores indicating motor impairment at school age that was not identified at 18 months by Bayley-III. Most children with low MABC scores needed support at school. Sub-optimal MABC-2 scores indicate need for detailed school-age cognitive evaluation.

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