Higher risk for poor handwriting in Taiwanese children born late preterm

Background: Late-preterm and early-term births constitute a significant proportion of live births. However, handwriting skills of these two populations remain unclear. We aimed to investigate their risk for poor Chinese handwriting in grade two. Methods: In this observational study, 185 second graders born late preterm (34+0-36+6 weeks' gestation, n = 54), early term (37+0-38+6 weeks' gestation, n = 56), and full term (39+0-41+6 weeks' gestation, n = 75) without any intervention or diagnosis related to developmental de-lays were included. Their handwriting performance was rated by class teachers using the Chi-nese Handwriting Evaluation Form (CHEF), which is a standardized handwriting scale including five handwriting dimensions (construction, accuracy, directionality, speed, and pencil grasp). Results: After controlling for demographic risk factors, the late-preterm born group had a greater risk of having worse performance in the full form (adjusted odds ratio [aOR] = 3.93; p = .038) and construction dimension (aOR = 4.77; p = .009) of the CHEF than peers born at full term, whereas the risks were comparable for the early-and full-term born groups (aOR = 0.14-1.90; p = .073-0.453 in the handwriting dimensions). Conclusions: Late-preterm but not early-term born children were found to be at higher risk for poor Chinese handwriting in grade two. They particularly have difficulty with spatial construc-tion including size, spacing, and alignment of Chinese characters and components that may in-fluence handwriting legibility.