Fitzgerald, T.L.Cameron, K.L.Albesher, R.A.Mentiplay, B.F.Mainzer, R.M.Burnett, A.C.Treyvaud, K.Clark, R.A.Anderson, P.J.Cheong, J.L.Y.Doyle, L.W.Spittle, A.J.2024-09-162024-09-162024Archives of Disease in Childhood: Fetal and Neonatal Edition, 2024; 109(6):602-6081359-29981468-2052https://hdl.handle.net/2440/142338Published Online First 26 February 2024Objective: To investigate the effect of physical activity (PA) on development (motor, cognitive, social-emotional) in children 4–5 years old born <30 weeks’ gestation, and to describe subgroups of children at risk of low PA in this cohort. Design: Longitudinal cohort study. Patients: 123 children born <30 weeks were recruited at birth and assessed between 4 and 5 years’ corrected age. Main outcome measures: Development was assessed using the Movement Assessment Battery for Children, Second Edition (MABC-2), Little Developmental Coordination Disorder Questionnaire (L-DCDQ), Wechsler Preschool and Primary Scale of Intelligence (Fourth Edition; WPPSI-IV), and Strengths and Difficulties Questionnaire (SDQ). To measure PA, children wore an accelerometer and parents completed a diary for 7 days. Effects of PA on developmental outcomes, and associations between perinatal risk factors and PA, were estimated using linear regression. Results: More accelerometer-measured PA was associated with better MABC-2 aiming and catching scores (average standard score increase per hour increase in PA: 0.54, 95% CI 0.11, 0.96; p=0.013), and lower WPPSI-IV processing speed index scores (average composite score decrease per hour increase in PA: −2.36, 95% CI −4.19 to –0.53; p=0.012). Higher accelerometer-measured PA was associated with better SDQ prosocial scores. Major brain injury in the neonatal period was associated with less moderate-vigorous and less unstructured PA at 4–5 years. Conclusions: Higher levels of PA are associated with aspects of motor, cognitive and social-emotional skill development in children 4–5 years old born <30 weeks. Those with major brain injury in the neonatal period may be more vulnerable to low PA at preschool age.en© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.Child DevelopmentChild HealthPaediatricsJournal article10.1136/archdischild-2023-3260452024-09-12688236Anderson, P.J. [0000-0002-3730-4652]