Objective To identify perinatal and neonatal risk factors associated with developmental coordination disorder (DCD) in very low birthweight children (VLBW: <1250 g).

Design Retrospective design with prospectively collected cohort.

Setting Neonatal Follow-Up Program, Vancouver, Canada.

Patients 157 VLBW children assessed at 4–5 years who were free of cerebral palsy or major neurological impairment and had full-scale IQ >70.

Main outcome measure Movement Assessment Battery for Children (MABC).

Results Using ≤15th percentile on the MABC as the cut-off, 42% of our cohort developed DCD. Perinatal variables significantly associated with DCD were male sex, lower gestational age and lower birth weight, but only male sex and low birth weight independently predicted DCD, accounting for 20% of the variance in MABC scores. Compared with children without motor impairment, children with DCD had greater postnatal steroid exposure, longer duration of ventilation, more days on oxygen and significant retinopathy of prematurity, but only postnatal steroid exposure was significant, accounting for an additional 3% of the variance in MABC scores. Boys performed more poorly than girls on all subtests of the MABC.

Conclusions Male sex and low birth weight were significant predictors of DCD, suggesting that these infants should be followed for detection of this common, but under-recognised disorder. Future research aimed at identifying neural underpinnings of DCD and possible antecedents to the disorder is warranted.