Longitudinal examination of early motor ability and motor developmental change to predict two-year cognitive outcomes in preterm infants.

Preterm infants have high rates of motor and cognitive delays. Early motor function is a key indicator of later cognitive ability in preterm infants, yet the specificity of fine- and gross-motor contributions to cognition remains unclear. To determine (1) whether 12-month motor ability is a predictor for 24-month cognition when cognitive items are partitioned into established fine-motor-dependent (FMD) and fine-motor-minimized (FMM) cognitive subsets, and (2) whether fine- and gross-motor changes from 12 to 24 months are prospectively associated with 24-month global cognition. Data were drawn from a longitudinal NICU cohort (N = 114). Neuromotor status was assessed using the Hammersmith Infant Neurological Examination (HINE) and developmental metrics with the Bayley. Multivariate regression examined 12-month motor ability and 24-month cognitive outcomes (Aim 1). Linear regression modeled fine- (ΔFM) and gross-motor (ΔGM) change from 12 to 24 months predicting 24-month cognition (Aim 2), adjusting for gestational age, baseline cognition, and neuromotor classification. Higher 12-month motor ability predicted higher 24-month cognition across both FMD (β = 0.21, p = .037) and FMM (β = 0.07, p = .021) cognitive outcomes. Fine-motor change from 12 to 24 months (ΔFM) predicted higher 24-month cognition (β = 0.32, p = .002), whereas gross-motor change (ΔGM) was nonsignificant (β = -0.06, p = .74). Early global motor competence and subsequent FM growth both relate to cognitive development in preterm infants. Results suggest a developmental shift from generalized motor development to FM specialization across the second year, identifying FM progression as a potential marker of cognitive advancement in early childhood.