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BMJ 2009; 339 doi: (Published 02 December 2009) Cite this as: BMJ 2009;339:b5148

Very preterm babies have enduring motor deficits

Babies born very early or very small often have impaired motor development that lasts for years, according to a meta-analysis of 41 observational studies that included more than 9000 children. Their scores on three established tests of motor performance fell behind peers by 6 months of age, and stayed low through the early educational years and into adolescence.

Children in these studies were born at a mean of 28 weeks, weighing a mean of 1060 g. The authors found an overall deficit of around 13 points on a 100 point scale measuring fine and gross motor development in infants (one subscale of the Bayley scales of infant development version II). This difference—and others identified by scales measuring balance, ball skills, agility, coordination, dexterity, and running speed—would be clearly noticeable to children and their families, says an editorial (p 2257). Affected children find it hard to compete with their peers in school because such impairments have knock on effects on children’s ability to write, draw, learn, spell, play sports, and take part in other extracurricular activities.

Motor problems are highly treatable, and more should be done to support these children through early life and school, says the editorial. Being born very preterm or at very low birth weight need not ruin a child’s chances in life.

An uncertain future for intravenous drugs in out of hospital cardiac arrest

Intravenous drugs such as adrenaline and atropine have been part of cardiopulmonary resuscitation for decades. More recently, worries about toxicity have prompted researchers to evaluate formally whether these drugs save lives, or cost them. The results from one Norwegian trial were mixed. Patients treated with rapid intravenous access and drugs according to the usual protocols did better in the short term than controls treated without intravenous access until spontaneous circulation returned (43% (178/418) v 29% (126/433) survived as far as hospital; P<0.001). But they …

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