Motor development of preterm infants assessed by the Alberta Infant Motor Scale: systematic review article

Fuentefria, Rubia do N.; Silveira, Rita C.; Procianoy, Renato S.

doi:10.1016/j.jped.2017.03.003

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Review articles • J. Pediatr. (Rio J.) 93 (4) • Jul-Aug 2017 • https://doi.org/10.1016/j.jped.2017.03.003 copy

Motor development of preterm infants assessed by the Alberta Infant Motor Scale: systematic review article^☆ ☆ Please cite this article as: Fuentefria RN, Silveira RC, Procianoy RS. Motor development of preterm infants assessed by the Alberta Infant Motor Scale: systematic review article. J Pediatr (Rio J). 2017;93:328-42.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

Premature newborns are considered at risk for motor development deficits, leading to the need for monitoring in early life. The aim of this study was to systematically review the literature about gross motor development of preterm infants, assessed by the Alberta Infant Motor Scale (AIMS) to identify the main outcomes in development.

Data source:

Systematic review of studies published from 2006 to 2015, indexed in Pubmed, Scielo, Lilacs, and Medline databases in English and Portuguese. The search strategy included the keywords: Alberta Infant Motor Scale, prematurity, preterm, motor development, postural control, and follow-up.

Data summary:

A total of 101 articles were identified and 23 were selected, according to the inclusion criteria. The ages of the children assessed in the studies varied, including the first 6 months up to 15 or 18 months of corrected age. The percentage variation in motor delay was identified in the motor outcome descriptions of ten studies, ranging from 4% to 53%, depending on the age when the infant was assessed. The studies show significant differences in the motor development of preterm and full-term infants, with a description of lower gross scores in the AIMS results of preterm infants.

Conclusions:

It is essential that the follow-up services of at-risk infants have assessment strategies and monitoring of gross motor development of preterm infants; AIMS is an assessment tool indicated to identify atypical motor development in this population.

KEYWORDS
Prematurity; Child development; Motor development

Author/place	Methods and sample (n)	GA and age at evaluations	Main results	Associated risk factors	Strengths and limitations
Pin et al. (2009)¹¹11 Pin TW, Darrer T, Eldridge B, Galea MP. Motor development from 4 to 8 months corrected age in infants born at or less than 29 weeks' gestation. Dev Med Child Neurol. 2009;51:739-45./Australia	- Longitudinal - 62 PT and 53 full-term	- GA ≤ 29 w - 4-8 m of CoA	- At 4 m: PT scored lower in all subscale scores and in the total score - At 8 m: PT scored lower in the subscales scores of sitting and standing and total score	- No description	- PT with GA ≤29 w had different MD compared to full-term peers at 4 and 8 m; with motor skills that progress in a differentiated way - Motor delay in more vertical positions (sitting and standing) at 8 m of CoA - Limitations on the generalization of results; and on the lack of potential confounders
Prins et al. (2010)³⁶36 Prins SA, von Lindern JS, van Dijk S, Versteegh FG. Motor development of premature infants born between 32 and 34 weeks. Int J Pediatr. 2010. pii: 462048./The Netherlands	- Longitudinal - 70 PT	- IGA 32 < 34 w - 3, 6, and 9 m of CoA and 4 years	- At 3 m: 12% had motor delay (n = 8) - At 9 m: 32% had motor delay (n = 20) - At 4 years: 17% had motor delay (n = 12)	- No association of MD with GA, BW, Apgar score, and gender	- AIMS results in the first year of life of moderate preterm infants were not predictive of outcomes in MD at 4 years of age - Limitations regarding losses to follow-up; researchers were not blinded to GA; small sample size
van Haastert et al. (2006)¹³13 van Haastert IC, de Vries LS, Helders PJ, Jongmans MJ. Early gross motor development of preterm infants according to the Alberta Infant Motor Scale. J Pediatr. 2006;149:617-22./The Netherlands	- Cross-sectional, prospective - 800 PT	- GA ≤32 w - 1, 6, 12, 15, and 18 m of CoA	-The mean scores of the PT were significantly lower than those born at term, at all age levels	-Motor delay was associated with: BW (<1250 g) at 6-7 m and 15-16 m; gender at 7-8 m and number of fetuses at 5-6 m	- Existence of a PT-specific MD trajectory reflecting a typical MD variant - The study shows a percentage curve for PT, indicating a cutoff point for motor intervention at 4 and 8 m: percentile < 25 - Limitations on the generalization of results
Pin et al. (2010)¹²12 Pin TW, Eldridge B, Galea MP. Motor trajectories from 4 to 18 months corrected age in infants born at less than 30 weeks of gestation. Early Hum Dev. 2010;86:573-80./Australia	- Longitudinal - 58 PT and 52 full-term	- GA ≤29 w - 4, 8, 12 and 18 m of CoA	- Total scores of PT were lower in all 4 age groups - An evident difference was found in the subscale sitting at 8 m of CA	- Poor MD was associated with: HIV, chronic lung disease, pre- and postnatal corticoid, and Apgar score (in certain age groups)	- Children born ≤29 w GA had a different motor trajectory from their full-term peers from 4 to 18 m of CoA; with motor skills that progress differently over time - Due to the small sample size of the study, it was not possible to analyze all factors associated with MD; Limitations on the generalization of results
Formiga and Linhares (2011)¹⁰10 Formiga CK, Linhares MB. Motor development curve from 0 to 12 months in infants born preterm. Acta Paediatr. 2011;100:379-84./Brazil	- Cross-sectional - 308 PT	- GA < 37 w and BW < 2500 g - 1 at 12 m (12 independent groups)	- The MD of Brazilian PTs was lower than that of the AIMS normative sample in all age groups evaluated (1-12 m)	- No description	- The study demonstrates that the MD of PT is different from their full-term peers - It features an MD curve for Brazilian PT, according to the distribution of AIMS percentiles; indicating the 5th and 10th percentiles as the best cutoffs to identify motor delay - Limitations regarding the study design and the sample (it was not constant during the analyzed m)
Manacero and Nunes (2008)³²32 Manacero S, Nunes ML. Evaluation of motor performance of preterm newborns during the first months of life using the Alberta Infant Motor Scale (AIMS). J Pediatr (Rio J). 2008;84:53-9./Brazil	- Cross-sectional - 44 PT	- GA 32 < 34 w (sample stratified according to BW) - 40th w of gestational age, at 4 and 8 m of CoA	- The percentiles varied in both groups between 10% and 90%; with MD considered normal and similar acquisition rate in both groups - Means of the group ≤ 1750 g: 40th w: 43.2%; 4th m: 42.9%; 8th m 43.9% - Means of the group ≥1750 g: 40th w: 47%; 4th m 47.8%; 8th m: 45.7%	- AIMS scores did not show association with BW	- The PT showed a normal progressive sequence of motor skill onset, within an appropriate mean percentile in the AIMS (43.2-45.7%), independently from BW - Limitations related to group stratification, with a BW cutoff < 1750 g, not 1500 g, as it has been traditionally used
Wang et al. (2010)²³23 Wang TN, Howe TH, Hinojosa J, Hsu YW. Postural control of pre-term infants at 6 and 12 months corrected age. Early Hum Dev. 2010;86:433-7./Taiwan	- Retrospective - 93 PT with BW < 1501 g	- GA 24 < 35 w - 6 and 12 m of CoA	- At 6 m: 30.1% (n = 28) had motor delay - At 12 m: 16.1% (n = 15) had motor delay - At 6 and 12 m of CoA the PT showed differences in the mean score of AIMS, showing poor MD when compared to the normative data	- At 6 m: Correlation of motor delay with medical complications, BW, maternal level of schooling and Apgar score in the 5th min - At 12 m: Correlation with medical complications and maternal age	- The study substantiates and reinforces the importance of early assessment at follow-up in the first 6 m of CoA of high-risk PT - Gives evidence that the influence of social and environmental factors on MD of PT is significant - The sample size was relatively small, with only 93 cases for nine independent variables; the study design was retrospective and all variables were extracted from a convenience cohort sample
Restiffe and Gherpelli (2012)²⁴24 Restiffe AP, Gherpelli JL. Differences in walking attainment ages between low-risk preterm and healthy full-term infants. Arq Neuropsiquiatr. 2012;70:593-8./Brazil	- Prospective - 101 PT and 52 full-term	- GA 25 < 36 w - 1-18 m of CoA (monthly evaluations)	- There was no difference between PT and full-term newborns in the mean AIMS scores, except for the eighth, ninth and tenth m - The mean age at independent gait acquisition in PT newborns was 381.6 days, and in full-term, 368.6 days	- Variables associated with delayed gait acquisition: BW, birth length, and duration of neonatal hospitalization	- The study presents evidence that premature infants acquire independent gait later than full-term infants, with a delay of approximately one month - The variables birth weight and length and duration of neonatal hospitalization were predictive of delayed gait acquisition in PT
Spittle et al. (2015)¹⁷17 Spittle AJ, Lee KJ, Spencer-Smith M, Lorefice LE, Anderson PJ, Doyle LW. Accuracy of two motor assessments during the first year of life in preterm infants for predicting motor outcome at preschool age. PLoS One. 2015;10:e0125854./Australia	- Cohort, prospective - 138 PT	- GA < 30 w - 4, 8 and 12 m of CoA and at 4 years	- At 4 m: 22% (n = 19) had percentile <10th - At 8 m: 26% (n = 23) had percentile <5th; - At 12 m: 36% (n = 31) had percentile <5th Cerebral palsy (4 years): 7% (n = 6) had CP	- No description	- AIMS accuracy was better when the three assessments over time showed delay, rather than only one. AIMS showed to be less accurate at 12 m and more accurate at 4 m for motor deficits found at 4 years, including CP - The strengths include the use of standardized motor assessments for a long time and the high follow-up rates - Limitations are related to the difficulty of evaluation at 4 years of age
Restiffe and Gherpelli (2006)²⁶26 Restiffe AP, Gherpelli JL. Comparison of chronological and corrected ages in the gross motor assessment of low-risk preterm infants during the first year of life. Arq Neuropsiquiatr. 2006;64:418-25./Brazil	- Cohort, observational and prospective - 43 PT	- IG 26 < 36 w - 0-13 m of CoA (monthly evaluations)	- The mean gross MD scores of the PT were different from those of the AIMS standard, only when using chronological age. When correcting for age, the scores were similar - All PT were able to walk without help before 18 m of CoA	- No description	- The results suggest that, to more accurately identify children with real motor delay by AIMS, the chronological age should be corrected according to the degree of prematurity, preventing false negatives
Valentini and Saccani (2012)¹⁵15 Valentini NC, Saccani R. Brazilian validation of the Alberta Infant Motor Scale. Phys Ther. 2012;92:440-7./Brazil	- Cross-sectional and longitudinal - 766 children and 22 professionals	- 0-18 m	- The PT showed differences in relation to the full-term children regarding the gross and percentile scores; PT scores were the lowest - The results of premature infants were associated with atypical MD or at risk situation (the age used was not corrected)	- No description	- The final translation and the edited scale resulted in the Brazilian-Portuguese version of AIMS (AIMS-BR); a validated and reliable tool to assess child development and plan an intervention for Brazilian children. - Limited predictive validity was observed, which may be due to the short time during which the groups were followed longitudinally
Fetters and Huang (2007)¹⁹19 Fetters L, Huang HH. Motor development and sleep, play, and feeding positions in very-low-birth weight infants with and without white matter disease. Dev Med Child Neurol. 2007;49:807-13./Boston, USA	- Cohort - 68 children (30 PT with VLBW and with white matter lesions; 21 PT with VLBW and no white matter lesions; 17 full-term infants)	- GA 24 < 31 w and 6 days - 1, 5 and 9 m of CoA	- There were no differences in the scores of the subscales, the total score and the AIMS percentile between PT without lesions and full-term babies, at 1 and 5 m - At 9 m, there was a difference in the total score and the AIMS percentile between PT with and without white matter lesion - The group of PT with white matter lesion had the lowest scores at AIMS	- AIMS scores were not associated with: gender, ethnicity, GA, or BW - The prone sleeping position was positively associated with MD - At 5 m, playing in the prone position had positive effects on MD	- The data suggest that sleeping in the supine position does not appear to have a negative effect on MD; the prone position appears to have a positive impact - At 5 m, sleeping and playing in the prone position were significantly associated with AIMS scores - Limitations: sample loss over time
Formiga et al. (2010)³¹31 Formiga CK, Cezar ME, Linhares MB. Avaliação longitudinal do desenvolvimento motor e da habilidade de sentar em crianças nascidas prematuras. Fisioter Pesqui (São Paulo). 2010;17:102-7./Brazil	- Prospective - 10 children	- PT with LBW (mean GA: 32.8 w) - 4-8 m of CoA	- From 4 to 5 m: 50% with suspected MD; 40% with motor delay - From 5 to 6 m: 30% with suspected MD; 40% with motor delay - From 7 to 8 m: 50% with suspected MD; 30% with motor delay - The mean score in the sitting position increased over the three assessments; the setting position showed a high correlation with the other acquisitions	- No description	- AIMS allowed detecting MD delay in PT children born with low weight up to the 8th m of CoA, mainly regarding sitting capacity - There was a greater correlation between the sitting and the prone position at each age evaluated - Limitations regarding sample size and absence of control group
Cabral et al. (2014)²⁰20 Cabral TI, Pereira da Silva LG, Tudella E, Simões Martinez CM. Motor development and sensory processing: a comparative study between preterm and term infants. Res Dev Disabil. 2014;36C:102-7./Brazil	- Cross-sectional and comparative study - 30 children (15 PT and 15 full-term)	GA: PT < 37 w - 4-6 m of CoA	- 53% (n = 8) of PT had percentile equal to or lower than 5 at AIMS - There was no difference in AIMS total score, the groups were similar in terms of MD	- No description	- High MD variability observed among the subjects, since both groups had children with high and low motor performance - The sample size limited analyses of correlation between important study variables
Wang et al. (2013)³³33 Wang LY, Wang YL, Wang ST, Huang CC. Using the Alberta Infant Motor Scale to early identify very low-birth-weight infants with cystic periventricular leukomalacia. Brain Dev. 2013;35:32-7./Taiwan	- Longitudinal - 35 PT with PVL; 70 PT without PVL; 76 full-term infants	- GA ≤ 27 w - 6, 12, and 18 m of CoA	- Differences were found in total scores between PT without PVL and full-term infants only at 6 and 12 m; and no difference was found at 18 m - At 6, 12, and 18 m, differences were found in the total scores between: PT with PVL vs. PT without PVL; PT with PVL vs. full-term infants - At 18 m, only PT with PVL were different from PT without PVL and of full-term infants	- No description	- First study that shows MD results through the AIMS of VLBW PT with PVL - VLBW PT with cystic PVL are at greater risk of motor impairment and delays in the gross motor milestones when compared to PT without PVL, with the supine subscale being the most useful to discriminate them, as early as 6 m of CoA - VLBW PT without cystic PVL reach the MD of their full-term peers at 18 m of CoA
Nuysink et al. (2013)²⁷27 Nuysink J, van Haastert IC, Eijsermans MJ, Koopman-Esseboom C, Helders PJ, de Vries LS, et al. Prediction of gross motor development and independent walking in infants born very preterm using the Test of Infant Motor Performance and the Alberta Infant Motor Scale. Early Hum Dev. 2013;89:693-7./The Netherlands	- Prospective cohort - 95 PT	- GA < 30 w or BW < 1000 g - 3, 6, and 15 m of CoA	- The mean age of gait acquisition was 15.7 m of CoA (50% of the sample walked at this age) - Children born with less than 30 w of GA started walking independently approximately 3 m after their full-term peers, even with age correction	- The level of gross motor maturation at 6 m of CA, and ethnicity were clearly associated with age at independent gait acquisition	- AIMS at 3 m of CoA could not reliably predict the gross MD or walking skills at 15 m of very premature babies - A clinical implication is that the CoA of 3 m can be considered precocious to give predictive validity on the outcomes in the later MD of preterm infants - Limitations related to sample size and the possibility of memory and selection bias in the mean ages of the evaluations
Burger et al. (2011)²⁵25 Burger M, Frieg A, Louw QA. General movements as a predictive tool of the neurological outcome in very low and extremely low birth weight infants - a South African perspective. Early Hum Dev. 2011;87:303-8./South Africa	- Descriptive and prospective - 115 children with BW ≤ 1250 g	- GA: 27 < 36 w - 3 and 12 m of CoA	- 22 children (19%) had a percentile below 5 at 12 m of CoA - The mean percentile of evaluations at 12 m of CoA was 35.0 ± 25.1	- No description	- AIMS at 12 m, was used in the child's follow-up, evaluated using the Prechtl method at 3 m, which showed high predictive validity, sensitivity and specificity - High specificity and low false positive results do not add unnecessary referral of infants to the already overburdened and underdeveloped rehabilitation services
Snider et al. (2008)²²22 Snider LM, Majnemer A, Mazer B, Campbell S, Bos AF. A comparison of the general movements assessment with traditional approaches to newborn and infant assessment: concurrent validity. Early Hum Dev. 2008;84:297-303./Netherlands	- Prospective cohort - 100 children	- GA ≤ 32 w and BW < 1500 g - 34 w; at term (38-40 w) and at 3 m of CoA	- 37% of the children (n = 37) had abnormal development at 3 m of CoA (percentile < 10) - The mean percentile at 3 m of CoA was 17.1 (11.7), ranging from 2 to 55	- No description	- AIMS was used in the follow-up evaluation at 3 m of CoA - A low power ratio (r ≤ 0.25) was found between general movements assessment and the tests used at 3 m - Limitations: early evaluations, no late follow-up
Souza and Magalhães (2012)³⁵35 Souza ES, Magalhães LC. Desenvolvimento motor e funcional em crianças nascidas pré-termo e a termo: influência de fatores de risco biológico e ambiental. Rev Paul Pediatr. 2012;30:462-70./Brazil	- Observational and longitudinal - 60 children (30 PT and 30 full-term infants)	- GA ≤ 34 w and BW ≤ 1500 g - 12, 15, and 18 m of CoA	- PTG walked at 13.8 ± 2.0 m of CoA (415 ± 59 days) and the CG, at 12.3 ± 2 m (368 ± 62 days) - No differences were found between the groups at 12 and 15 m - There was a difference between the groups only at 18 m	- The correlation between GA and AIMS at 12 m of CoA was not significant	- Although no difference was found in AIMS at 12 and 15 m, power was 0.95 at both ages. These results raise questions about the discriminatory power of AIMS to identify the gross motor delay in Brazilian children after 12 m - Limitations: limited sample size and the non-inclusion of the economic level as a criterion for matching; the use of imported tests; and the use of parents’ reports to allow the comparison of the time to gait acquisition
Maia et al. (2011)³⁴34 Maia PC, Silva LP, Oliveira MM, Cardoso MV. Motor development of preterm and term infants - using the Alberta Infant Motor Scale. Acta Paul Enferm. 2011;24:670-5./Brazil	- Longitudinal and comparative - 48 children (24 PT and 24 full-term)	- GA 32 < 36.5 w - 4 and 6 m of CoA	- There was a difference between the groups in the standing position at 4 m; and at 6 m, in the prone, sitting and standing positions - The total scores at 6 m indicated a difference between the groups, with the PT showing lower scores	- No description	- In the total score and in the percentile, at 4 m of CoA, there was no great difference in the four positions. At 6 m, the full-term group showed a higher score in the four AIMS positions - Limitations regarding sample size and the inclusion of children from other regions of Brazil
de Castro et al. (2007)³⁷37 de Castro AG, Lima Mde C, de Aquino RR, Eickmann SH. Sensory oral motor and global motor development of preterm infants. Pro Fono. 2007;19:29-38./Brazil	- Exploratory - 55 PT	- GA < 37 w - Between 4 and 5 m of CoA	- GA between 29 and 34 w: 26% (n = 8) with percentile < 10 - GA between 35 and 36 w: 4% (n = 1) with percentile < 10 - Considering all the sample (GA < 37 w): 16.4% (n = 9) with percentile < 10	- The percentage of children with AIMS score below percentile 10 was higher among those born at lower GA (29 to 34 w)	- More preterm infants (29-34 w of GA) had lower scores when assessed by the AIMS, when compared to the PT with 35 and 36 w of GA - The results reinforce the need for more dynamic therapeutic procedures, with an emphasis on interdisciplinary and transdisciplinary action
Formiga et al. (2015)³⁸38 Formiga KM, Vieira ME, Linhares MB. Avaliação do desenvolvimento de bebês nascidos pré-termo: a comparação entre idade cronológica e corrigida. J Hum Growth Dev. 2015;25:230-6./Brazil	- Cross- sectional - 182 PMT and LBW	- GA < 37 w - 2-4 m; 4-6 m; and 6-8 m (Three independent age groups	- 4-6 m: 47% of sample with atypical MD - 6-8 m: 36% of sample with atypical MD - There were differences in MD of the 3 age groups, when comparing CoA of chronological age	- No description	- The findings suggest that the corrected age is the best way to assess the actual performance of preterm infants at risk, especially in the first year of life - Study limitations regarding design and lack of follow-up of children older than 12 m
Formiga et al. (2013)²¹21 Formiga CK, Nonato JC, Amaral LE, Fagundes RR, Linhares MB. Comparação do desenvolvimento motor de lactentes pré-termo de duas amostras regionais brasileiras. J Hum Growth Dev. 2013;23:352-7./Brazil	- Cross-sectional - 70 PMT (CG of 43 PMT from another study)	- GA < 37 w and BW < 2500 g - Between 0 and 6 m of CoA	- 1 m: 30% with delay (percentile < 10) - 2 m: 20% with delay (percentile < 10) - 3rd m: 40% with delay (percentile < 10) - 4th m: 33% with delay (percentile < 10) - 5th m: 33% with delay (percentile <1 0) - 6th m: 43% with delay (percentile < 10) - There were no differences in the total score of the PMT infants by AIMS at any of the compared ages	- No description	- These results suggest that PMT infants from different regions, despite being submitted to different environmental influences, have similar MD - It is relevant to create follow-up programs for at-risk infants according to the region or municipality where they live - Although the samples of infants studied were considered homogeneous, in relation to GA and BW, differences were observed in some age groups evaluated

Author/year	Gestational age	Corrected age	Motor delay
Spittle et al. (2015)¹⁷17 Spittle AJ, Lee KJ, Spencer-Smith M, Lorefice LE, Anderson PJ, Doyle LW. Accuracy of two motor assessments during the first year of life in preterm infants for predicting motor outcome at preschool age. PLoS One. 2015;10:e0125854.	<30 w	4 m 8 m 12 m	22% (percentile < 10) 26% (percentile < 5) 36% (percentile < 5)
Prins et al. (2010)³⁶36 Prins SA, von Lindern JS, van Dijk S, Versteegh FG. Motor development of premature infants born between 32 and 34 weeks. Int J Pediatr. 2010. pii: 462048.	32 < 34 w	3 m 9 m	12% 32%
Snider et al. (2008)²²22 Snider LM, Majnemer A, Mazer B, Campbell S, Bos AF. A comparison of the general movements assessment with traditional approaches to newborn and infant assessment: concurrent validity. Early Hum Dev. 2008;84:297-303.	<32 w	3 m	37% (percentile < 10)
de Castro et al. (2007)³⁷37 de Castro AG, Lima Mde C, de Aquino RR, Eickmann SH. Sensory oral motor and global motor development of preterm infants. Pro Fono. 2007;19:29-38.	29 < 34 w 35 < 36 w	Between 4 and 5 m Between 4 and 5 m	26% (percentile < 10) 4% (percentile < 10)
Burger et al. (2011)²⁵25 Burger M, Frieg A, Louw QA. General movements as a predictive tool of the neurological outcome in very low and extremely low birth weight infants - a South African perspective. Early Hum Dev. 2011;87:303-8.	27 < 36 w	12 m	19% (percentile < 5)
Formiga et al. (2015)³⁸38 Formiga KM, Vieira ME, Linhares MB. Avaliação do desenvolvimento de bebês nascidos pré-termo: a comparação entre idade cronológica e corrigida. J Hum Growth Dev. 2015;25:230-6.	<37 w	4-6 m 6-8 m	47% 36%
Formiga et al. (2013)²¹21 Formiga CK, Nonato JC, Amaral LE, Fagundes RR, Linhares MB. Comparação do desenvolvimento motor de lactentes pré-termo de duas amostras regionais brasileiras. J Hum Growth Dev. 2013;23:352-7.	<37 w	1 m 2 m 3 m 4 m 5 m 6 m	30% (percentile < 10) 20% (percentile < 10) 40% (percentile < 10) 33% (percentile < 10) 33% (percentile < 10) 43% (percentile < 10)
Wang et al. (2010)²³23 Wang TN, Howe TH, Hinojosa J, Hsu YW. Postural control of pre-term infants at 6 and 12 months corrected age. Early Hum Dev. 2010;86:433-7.	24 < 35 w	6 m 12 m	30.1% 16.1%
Cabral et al. (2014)²⁰20 Cabral TI, Pereira da Silva LG, Tudella E, Simões Martinez CM. Motor development and sensory processing: a comparative study between preterm and term infants. Res Dev Disabil. 2014;36C:102-7.	<37 w	4-6 m	53% (percentile ≤ 5)
Formiga et al. (2010)³¹31 Formiga CK, Cezar ME, Linhares MB. Avaliação longitudinal do desenvolvimento motor e da habilidade de sentar em crianças nascidas prematuras. Fisioter Pesqui (São Paulo). 2010;17:102-7.	Mean GA = 32 w	4-5 m 5-6 m 7-8 m	40% 40% 30%

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[1] * Corresponding author. E-mail:rprocianoy@gmail.com (R.S. Procianoy).