Master Theses UMCG - University of Groningen
English | Nederlands

The association between gestational age, attainment of smiling and walking,and development at school entry.

(2017) Dokkum, N.H. van

BACKGROUND: Developmental milestones, such as ‘smiling’ and ‘walking’, are used worldwide to monitor development of children. Preterm-born children reach developmental milestones later than term-born children. Exact attainment ages and predictive values for later neurocognitive functioning of these milestones for preterm-born children are still largely unknown.
AIM: First, to assess the association between gestational age (GA) and attainment ages of smiling and walking (smiling-age, walking-age). Second, to assess the predictive values of smiling-age and walking-age for developmental delay at age 4 years.
METHODS: Smiling-age was recorded for 201 term-born and 454 preterm-born children and walking-age for 425 term-born and 1,080 preterm-born children. Development was assessed at 4 years with the Ages and Stages Questionnaire (ASQ). We assessed the association between GA and attainment ages with Pearson correlation coefficients. Next, we assessed crude and adjusted odds for failing ASQ domains, with later smiling-age and walking-age.
RESULTS: GA was correlated with smiling-age ( -0.742, P<0.001), and walking-age ( -0.415, P<0.001). For every week a child smiled later, the adjusted odds for an abnormal ASQ-communication score increased with 16% (odds ratio [OR] 1.16, 95%-confidence interval [CI] 1.02-1.32). Smiling-age was not associated with other ASQ-domain scores. For every month a child walked later, the additional odds for an abnormal ASQ-total score was 14% (OR 1.14, CI 1.07-1.21). Walking-age was associated with failing on underlying gross motor, fine motor and problem solving ASQ domains.
CONCLUSIONS: Smiling-age is strongly associated with GA and predicts communication delay at age 4, independent of GA. The association of walking-age to GA is moderate, and predictive of developmental delay in several domains at age 4 years, independent of GA.

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