From movement to mind: Early fine motor skills are associated with cognitive performance at school age in very preterm infants.

Background: Although preterm birth is associated with deficits in both motor and cognitive functioning, the association between early motor skills and cognitive outcomes at a later age remains underexplored.

Aim: To evaluate associations between motor skills at age 5.5 and cognitive functioning at age 8.

Methods: Single-center cohort study including children born below 30 weeks' gestation or below 1000 g, between September 1st 2010 and September 1st 2015. Three motor skills (aiming and catching, balance and manual dexterity) were assessed at age 5.5 using the Movement Assessment Battery for Children, 2nd edition (MABC-2-NL). Total intelligence quotient and its five subdomains (fluid reasoning, processing speed, verbal comprehension, visual spatial, and working memory) were assessed at age 8 using the fifth version of the Wechsler Intelligence Scale for Children (WISC-V-NL). Multiple linear regression analysis was used to investigate associations between MABC-2-NL scores and WISC-V-NL outcomes.

Results: In total, 327 live born children without congenital malformations were included, of whom 281 survived to 8 years. Of these, 185 (66 %) had follow-up assessments at both 5.5 and 8 years. Scores on motor and cognitive subdomains were lower compared to the normative mean. Regression analysis showed that manual dexterity was significantly associated with better scores on all subdomains of cognitive performance, except for verbal comprehension.

Conclusion: Our main finding is that fine motor function at age 5.5 is associated with later cognitive performance. Early assessment of motor performance may be helpful for early diagnosis and targeted intervention to support optimal cognitive development of preterm children.