Article

We assessed motor and intellectual outcome in triplets at school age and
investigated the predictive value of perinatal and demographic factors. METHODS:
Seventy-one live-born newborn infants (24 triplet pregnancies) were prospectively
enrolled at birth. At the age of 6 years, 58 children (31 males, 27 females; mean
gestational age 31.2 wks [SD 2.2 wks]; mean birthweight 1622 g [SD 440 g])
returned for a neurodevelopmental examination. A comparison group for triplets
born before 32 gestational weeks comprising 26 gestational age-, birthweight-,
and sex-matched singletons was also recruited (mean gestational age 30.1 wk [SD
1.5 wk]; mean birthweight 1142 g [SD 210 g]; 12 males, 14 females). The Zurich
Neuromotor Assessment was used to examine motor performance, and intellectual
abilities were assessed with the Kaufman Assessment Battery for Children (K-ABC).
RESULTS: Motor performance and movement quality in these individuals was
significantly reduced compared with the test norms for all motor tasks (p<0.001)
other than static balance. The mean values on the Mental Processing Composite
(95.3, SD 8.4) and the Achievement Scale (90.1, SD 13.8) of the K-ABC were also
lower than those in the test reference (p<0.05 and p<0.01 respectively). Triplets
born at less than 32 weeks' gestation showed poorer pure motor and adaptive gross
motor performance (both p<0.05) than, but similar intellectual performance to,
the gestational age-, birthweight- and sex-matched singletons. Poor outcome was
predicted by low socio-economic status and by intertriplet birthweight
discordance (both p<0.01). INTERPRETATION: Triplets were at an increased risk of
mild motor and intellectual impairments. This finding is important for tailoring
therapeutic interventions for these children and for parental counselling. Very
preterm triplets showed similar outcomes to the singleton comparison children,
except that they had poorer motor performance. Low socio-economic status was a
major risk factor for impaired intellectual development. In addition, birthweight
discordance may also be considered a predictor for poor long-term motor and
intellectual outcome in triplets.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2011 Mac Keith Press.
Triplés

Langue : ANGLAIS