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Motor Development of Triplets: A Japanese Prospective Cohort Study

Published online by Cambridge University Press:  21 February 2012

Yoshie Yokoyama*
Affiliation:
Department of Community Health Nursing, Osaka City University, Japan. yyokoyama@nurs.osaka-cu.ac.jp
Masako Sugimoto
Affiliation:
Department of Community Health Nursing, Osaka City University, Japan; Nishinomiya City Public Health Center, Nishinomiya, Japan.
Yu Miyake
Affiliation:
Department of Community Health Nursing, Osaka City University, Japan.
Jun Sono
Affiliation:
Nishinomiya City Public Health Center, Nishinomiya, Japan.
Kenge Mizukami
Affiliation:
Nishinomiya City Public Health Center, Nishinomiya, Japan.
Jaakko Kaprio
Affiliation:
Department of Public Health and Institute for Molecular Medicine, University of Helsinki, Finland; Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland.
Karri Silventoinen
Affiliation:
Population Research Unit, Department of Social Research, University of Helsinki, Finland.
*
*ADDRESS FOR CORRESPONDENCE: Yoshie Yokoyama, Department of Community Health Nursing, Osaka City University, 1-5-17 Asahi-machi, Abeno-ku, Osaka 545-0051, Japan.

Abstract

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We analyzed whether motor development in early life is different between singletons and triplets in Japan. The motor development was reported by mothers by postal questionnaire for 1,121 triplet children and in regular health check-ups for 13,906 singleton children. Children who were suspected of having neurological abnormality or disability were excluded from the analysis. The ages of milestone achievements were significantly higher in triplets for each outcome compared to singletons. Further, after adjustment for gestational age, birthweight, and birth length, the differences were significant for maintaining head, sitting alone and standing holding on. In children with birthweight of 2 kg or more, the ages of milestone achievements were significantly higher in triplets for each outcome compared to singletons, except walking holding on. Moreover, after adjustment for the confounding factors, the differences were significant for sitting alone and walking independently. On the contrary, singletons attained motor development facilitating crawling, walking holding on, and walking independently slower than triplets among those children with birthweight of 2 kg or less after adjustment for gestational age. In conclusion, triplets are overall at higher risk for the delay of gross motor milestones as compared to singletons independently of birth-related factors. In contrast, among children with a birthweight of less than 2 kg, singletons showed slower motor development than triplets after adjusting for gestational age. There is an obvious need to apply developmental standards that consider at least both multiple birth status (singleton, twin or triplet) and birthweight.

Type
Articles
Copyright
Copyright © Cambridge University Press 2011