Developmental Coordination Disorder in School-Aged Children Born Very Preterm and/or at Very Low Birth Weight: A Systematic Review

Objective: To systematically review and synthesize the literature to document the association between infants born very preterm and/or very low birth weight (VLBW) and the presence of developmental coordination disorder (DCD) at school age. Methods: Seven databases were systematically searched. Studies were included if they examined very preterm (< 32 weeks) and/or VLBW (< 1500 g) infants to school age (age, 5-18 years), had a full-term and/or normal birth weight comparison group, and used a formal measure of motor impairment. Studies that included only infants who were small for gestational age or diagnosed with cerebral palsy were excluded. Two independent reviewers completed abstract and full-text screening, data extraction, and quality assessment of included studies. Results: Sixteen articles were included, with 7 studies incorporated into 2 meta-analyses using cutoff scores of either < 5th or 5-15th percentile on the Movement Assessment Battery for Children. Both analyses showed a significant increase in the likelihood of DCD for children born very preterm and/or 1500 g or less, with odds ratios of 6.29 (95% confidence interval, 4.37-9.05, p < .00001) and 8.66 (95% confidence interval, 3.40-22.07, p < .00001) for < 5th or 5-15th percentile scores, respectively. Conclusions: Consistent across studies, DCD is more prevalent in the VLBW/very preterm population than full-term/normal birth weight control children and the general school-age population, with significantly greater odds of developing the disorder. Clinical practice should focus on early identification of and intervention for children with DCD, while research should focus on determining the mechanisms underlying DCD in the preterm population. (J Dev Behav Pediatr 32:678-687, 2011)