To Örebro University

Children born extremely preterm (EPT) are at increased risk for brain injury and developmental impairments. CP and non-CP motor difficulties are common. The overall aim of this thesis was to describe longitudinal motor development, deepen understanding of underpinning brain morphology, and study access to motor-related health care in this population.

Study I showed that the prevalence of a non-optimal neurological condition declined with age. Nevertheless, at 12 years, such conditions still remained significantly more frequent among children born EPT than among term-born peers, and were associated with reduced motor function.

Study II found that discrete white matter abnormalities were commonly observed at 8–11 years of age in children born EPT, but were not associated with neurodevelopmental outcomes.

Study III revealed a high prevalence of significant non-CP motor difficulties in children born EPT, although only a small proportion of affected children had received motor-related health care by 5.5 years of age. Access to motor-related health care was associated with bronchopulmonary dysplasia, hyperactivity, and involvement with additional health services beyond physiotherapy.

Study IV demonstrated that children born EPT with discrete white matter abnormalities exhibited greater mean and regional cortical thickness at 10 years of age compared with those without such abnormalities. Fine motorfunction at 2.5 years was a strong predictor of full-scale IQ in children born EPT with discrete white matter abnormalities.

A better understanding of the long-term consequences of EPT birth may, over time, inform strategies to improve clinical care and societal support for these children. Such knowledge can help create conditions that allow children born EPT to fully develop their abilities and reach their developmental potential.