Document Detail


Patterns of altered neurobehavior in preterm infants within the neonatal intensive care unit.
MedLine Citation:
PMID:  23036482     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate differences in neurobehavior between preterm infants at term and full-term infants, changes in neurobehavior between 34 weeks postmenstrual age (PMA) and term equivalent in the preterm infant, and the relationship of neurobehavior to perinatal exposures.
STUDY DESIGN: In this prospective cohort study, 75 infants were tested at 34 weeks PMA and again at term using the Neonatal Intensive Care Unit Network Neurobehavioral Scale. Infants underwent magnetic resonance imaging at term equivalent. Regression was used to investigate differences in the scale's domains of function across time and in relation to perinatal exposures.
RESULTS: At term equivalent, preterm infants exhibited altered behavior compared with full-term infants, with poorer orientation (P < .001), lower tolerance of handling (P < .001), lower self-regulation (P < .001), poorer reflexes (P < .001), more stress (P < .001), hypertonicity (P < .001), hypotonia (P < .001), and more excitability (P = .007). Preterm infants from 34 weeks PMA to term equivalent, demonstrated changes in motor functions with declining quality of movement (P = .006), increasing hypertonia (P < .001), decreasing hypotonia (P = .001), and changes in behavior with increasing arousal (P < .001), increasing excitability (P < .001), and decreasing lethargy (P < .001). Cerebral injury was associated with more excitability (P = .002). However, no associations were detected between any of the perinatal exposures and developmental change from 34 weeks PMA to term equivalent.
CONCLUSION: Preterm infants have altered neurobehavior in a broad number of domains at term equivalent. Cerebral injury alters neurobehavior but does not appear to impair early neurobehavioral changes. Important neurobehavioral changes occur before term, and this provides an opportunity for interventions in the neonatal intensive care unit.
Authors:
Roberta G Pineda; Tiong Han Tjoeng; Claudine Vavasseur; Hiroyuki Kidokoro; Jeffrey J Neil; Terrie Inder
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-10-01
Journal Detail:
Title:  The Journal of pediatrics     Volume:  162     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-26     Completed Date:  2013-04-26     Revised Date:  2014-03-09    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  470-476.e1     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 Mosby, Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Cognition Disorders / diagnosis*
Cohort Studies
Developmental Disabilities / diagnosis*,  etiology
Female
Humans
Infant Behavior*
Infant, Newborn
Infant, Premature / growth & development*,  psychology
Intensive Care Units, Neonatal
Magnetic Resonance Imaging
Male
Neurologic Examination
Prospective Studies
Risk Factors
Grant Support
ID/Acronym/Agency:
P30 HD062171/HD/NICHD NIH HHS; P30 HD062171/HD/NICHD NIH HHS; R01 HD057098/HD/NICHD NIH HHS; R01 HD057098/HD/NICHD NIH HHS; R01 HD058056/HD/NICHD NIH HHS
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