Physical Activity in School-Age Children Born Preterm

doi:10.1016/j.jpeds.2014.12.013

The Journal of Pediatrics

Volume 166, Issue 4, April 2015, Pages 877-883

https://doi.org/10.1016/j.jpeds.2014.12.013 Get rights and content

Objectives

To compare objectively measured physical activity in 11- and 15-year-old children who were born preterm with term-born controls and related physical activity measures to lung function measures.

Study design

We used data from the Avon Longitudinal Study of Parents and Children. We compared total physical activity, moderate-to-vigorous physical activity, and sedentary behavior between children born at 25-32, 33-34, 35-36, and 37-43 weeks' gestation at ages 11 and 15 years. At age 11 years, physical activity measures were correlated with lung spirometry recorded at age 7-9 years.

Results

Valid physical activity data at age 11 years were available for 5025, 197, 57, and 48 children born at 37-43, 35-36, 33-34, and 25-32 weeks' gestation, respectively. At age 15 years, valid physical activity data were available for 1829, 62, 32, and 24 children born at 37-43, 35-36, 33-34, and 25-32 weeks' gestation. Boys were more physically active than girls at both ages. There were no differences in total physical activity, moderate-to-vigorous physical activity, or sedentary behavior in children between the different gestation groups. Physical activity at age 11 years did not correlate with spirometry measures at age 7-9 years.

Conclusions

Physical activity was similar for the different gestational groups and did not correlate with lung spirometry. Physical activity does not appear to be limited in preterm-born children despite lung function deficits noted in childhood.

Section snippets

Methods

We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC).⁹ A total of 14 541 pregnant women with an expected delivery date of April 1, 1991, to December 31, 1992, were enrolled. There were 14 062 live born infants (13 988 alive at 1 year) who were subsequently followed up with questionnaires and clinical assessments. Ethical approval for the study was from the ALSPAC Ethics and Law Committee and the Local Research Ethics Committees. The study Web site contains details of

Results

Valid physical activity data at age 11 were available for 5327 children. A total of 5025 were term-born (≥37 weeks); 48 were born at 25-32 weeks, 57 were born at 33-34 weeks, and 197 were born at 35-36 weeks' gestation. At age 15, valid physical activity data were available for 1947 children, of which 1829 were term; 24 were born at 25-32 weeks, 32 were born at 33-34 weeks, and 62 were born at 35-36 weeks gestational age (Table I). The maximum duration of ventilation during the perinatal period

Discussion

Objectively measured levels of physical activity, in terms of both frequency and intensity, are remarkably similar in both preterm and term-born children despite deficits in lung function in the former. No relationship between lung function and physical activity measures was noted in this general population sample.

Previous studies have shown, using questionnaire based methods, that children born preterm report reduced physical activity compared with term-born peers.7, 20 Although these reports

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Cited by (22)

Motor outcomes of children born extremely preterm; from early childhood to adolescence
2021, Seminars in Perinatology
Citation Excerpt :
These results are consistent with other studies, with both decreased PA and increased sedentary behavior seen in children born VP compared with term.36,37 In contrast, other studies have reported no difference in accelerometer-measured PA levels between children/adolescents born EP/VP and at term.38-40 In studies using parent or self-report, differences in PA levels between those born VP/EP and their term-born peers seem to emerge in adolescence.
Children and adolescents born extremely preterm (EP; <28 weeks’ gestation) are at greater risk of motor impairment, including cerebral palsy and developmental coordination disorder, than their term born peers. Importantly, motor impairment has implications beyond performing motor skills; it negatively affects outcomes as diverse as school success, emotional wellbeing, physical health, and physical activity (PA) participation. This review will outline what is known about PA participation across childhood and adolescence for children born EP and term, recognising that PA may improve physical, social, and mental health outcomes. Critically, PA participation occurs in the context of children's and adolescents’ daily lives, and is influenced by the family, social and physical environment, as well as by the child's personal factors, such as motor impairment. Further research is needed to better understand PA participation levels and correlates for children and adolescents born preterm, to better inform effective and sustainable interventions.
Prospective Study of Physical Activity of Preterm Born Children from Age 5 to 14 Years
2019, Journal of Pediatrics
Citation Excerpt :
In light of the uncertainty within the literature to whether prematurity is related to physical activity in adolescence, this large representative national cohort from the UK provides evidence that according to parental reports between 5 and 11 years, very, moderate, and late preterm born children in the Millennium Cohort Study engaged as much in organized or un-organized physical activity as term born peers. These results are supported by other birth cohorts11,37,38 or studies linked to neonatal data that exclude chronic motor or lung impairment.39,40 Differences in physical activity participation were reported in preterm infants with impaired lung14 or motor function,16 and these subgroups of preterm children could profit from individually tailored advice regarding participation in physical activity.
To investigate whether level of prematurity (very, moderate, late preterm, vs full term) is associated with physical activity from childhood to adolescence and to identify factors in childhood that predict moderate-vigorous physical activity in early adolescence.
Parents reported on physical activity at the age 5, 7, and 11 years (n = 12 222-14 639) and adolescents self-reported on moderate-vigorous physical activity at 14 years (n = 10 974). At age 14 years, a subgroup was also assessed by wrist accelerometer (n = 4046).
Prematurity was associated with a small or no difference in physical activity at each time point. At age 14 years, moderate-vigorous physical activity in self-report and accelerometer was higher in male adolescents, those of white ethnicity, or higher parental education, having been taken to live sport events at age 5 or 7 years or having taken part in organized physical activity at 5 or 7 years.
In this representative national cohort study in the United Kingdom, preterm birth was not found to be associated with physical activity between 5 and 14 years. Organized physical activity and watching sport events early in life may increase moderate to vigorous physical activity in adolescents.
Cardiovascular Stress Test in People Born Preterm: A Peephole Into the Future <sup>∗</sup>
2018, Journal of the American College of Cardiology
Leisure Time Physical Activity in Young Adults Born Preterm
2017, Journal of Pediatrics
Citation Excerpt :
This was also the case in a subset of the present cohort who underwent accelerometry.34 Objective measurements during childhood have not been able to capture differences in physical activity between those born preterm and at term,35,36 except in 1 study of 7-year-old boys born very preterm (<32 weeks).37 One reason for this discrepancy may be that self-reporting and accelerometry capture different aspects of physical activity.
To evaluate the amount of self-reported physical activity in young adults born prematurely compared with those born at term.
Unimpaired participants of the Preterm Birth Study (Preterm Birth and Early Life Programming of Adult Health and Disease) birth cohort study were studied at age 23.3 ± 1.2 (SD) years: 118 born early preterm (<34 weeks), 210 late preterm (34-36 weeks), and 311 born at term (≥37 weeks, controls). The participants completed a validated 30-item, 12-month physical activity questionnaire. The annual frequency and total volume of conditioning and nonconditioning leisure time physical activity and commuting physical activity were calculated and the data analyzed by means of linear regression.
Adults born early preterm reported a 31.5% (95% CI, 17.4-43.2) lower volume of leisure time physical activity (in metabolic equivalents [MET] h/year) and had a 2.0-fold increased OR (1.2-3.3) of being in the least active quintile than controls. Lower amounts of conditioning, nonconditioning, and commuting physical activity all contributed to the difference. In addition, early preterm participants undertook less vigorous physical activity (≥6 MET). No differences in physical activity were found between the late preterm and control groups. Adjustments for potential early life confounders and current mediating health characteristics did not change the results.
Young adults born early preterm engage less in leisure time physical activities than peers born at term. This finding may in part underlie the increased risk factors of cardiometabolic and other noncommunicable diseases in adults born preterm. Low physical activity is a risk factor for several noncommunicable diseases and amenable to prevention.
Physical activity outcomes following preterm birth
2017, Paediatric Respiratory Reviews
Citation Excerpt :
Interestingly, we noted that this effect was not mediated by increased wheeze, which was independently associated with lower gestational age at birth (Figure 2). Our second study, using data from an earlier cohort of the Avon Longitudinal Study of Parents and Children, did not find a difference between MVPA or SED in preterm-born children when compared to term-born controls at the ages of 11 and 15 years [27]. However, levels of MVPA were substantially below the national recommendations (Figure 3).
Physical activity (PA) is an important mediator of health and disease. Many correlates may play an important role in explaining differences in PA between populations; however, the role of birth outcomes such as prematurity on levels of PA is relatively poorly represented in the literature. Children born preterm may be at risk for reduced levels of PA as they have increased respiratory symptoms as well as decrements in lung function and exercise capacity. Emerging evidence suggests that the effects are prevalent across the whole range of gestational age. This review summarises the current literature in regards to levels of PA in preterm-born children and also explores PA in cohorts of young adults in order to contextualise the possible impact on long term risks to respiratory health.
Sports participation and preterm birth: a nationwide birth cohort in Japan
2022, Pediatric Research

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: Funded by the UK Medical Research Council and the Wellcome Trust (092731), University of Bristol, the UK Medical Research Council (G0401540), and the National Heart, Lung, and Blood Institute (R01 HL071248-01A). The authors declare no conflicts of interest.

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Original ArticlePhysical Activity in School-Age Children Born Preterm

Objectives

Study design

Results

Conclusions

Section snippets

Methods

Results

Discussion

J Pediatr

Res Dev Disabil

Res Dev Disabil

Effect of late preterm birth on longitudinal lung spirometry in school age children and adolescents

Thorax

Effect of preterm birth on later FEV1: a systematic review and meta-analysis

Thorax

COPD: a pediatric disease

COPD

Foetal and childhood growth and asthma in adult life

Acta Paediatr

Review series: what goes around, comes around: childhood influences on later lung health? Long-term follow-up of infants with lung disease of prematurity

Chron Respir Dis

Aerobic capacity and exercise performance in young people born extremely preterm

Pediatrics

Cohort Profile: the 'children of the 90s'—the index offspring of the Avon Longitudinal Study of Parents and Children

Int J Epidemiol

Physical activity assessed by activity monitor and doubly labeled water in children

Med Sci Sports Exerc

Calibration of an accelerometer during free-living activities in children

Int J Pediatr Obes

Use of accelerometers in a large field-based study of children: protocols, design issues, and effects on precision

J Phys Act Health

Original Article
Physical Activity in School-Age Children Born Preterm