Behavioral states of premature infants: Implications for neural and behavioral development

Abstract

Nine premature and 28 full-term infants were observed in their homes for 7 hr when they were 2, 3, 4, and 5 weeks post-term, and the sleeping and waking states displayed by these infants were compared. For these comparisons, the observation day was divided into two mutually exclusive contexts: times when the baby was alone and times when the baby was with the mother. The premature infants spent more time alone (mean of 5.4 hr a day) than the full-terms (4.6 hr). Over the total 7-hr day, the premature infants spent more time in alert, nonalert waking activity, and sleep-wake transition than the full-terms, and they spent less time in drowse and total sleep. These results clearly indicate that, at the same post-term ages, the sleep-wake states of premature infants differ markedly from those of full-terms. Four states showed significant Group X Context interactions indicating that state differences between premature and full-term infants were also a function of the context in which the infants were observed. For example, the prematures exhibited more fuss or cry and more drowse when alone; whereas the full-terms exhibited more of these states when with their mothers. This finding of context-related differences between prematures and full-terms has implications for the conflicting reports in the literature, as heretofore the states of prematures and full-terms have been compared from observations made in a single situation. The results indicate that prematures exhibit significant commonality in their neurobehavioral development through the early post-term period despite heterogeneity among them in their exposure to prenatal, perinatal, and early postnatal stresses.

Parenting of low birth weight infants: A review of issues and interventions

“…Anders and Keener (1985) and Davis and Thoman (1987) report results that support the notion that preterm infants have a lower level of behavioral arousal whether asleep or awake which results in less time in interaction with their parents. In addition, Telzrow, Kang, Mitchell, Ashworth, and Barnard (1980) found that preterm infants tended to show an all-or-none response to stimulation and were more difficult to maintain in a quiet-awake state.…”

Developmental Care Does Not Alter Sleep and Development of Premature Infants

“…Sleep measures have been demonstrated to be very sensitive indices of central nervous system functional status. 9,11,[25][26][27][28] Our MMS assessment was not performed during the earlier course of the intervention; therefore, we do not have data regarding the acute effects of NIDCAP on sleep. The hypothesis that there is improved central nervous system development as measured by sleep quantity and maturation resulting from individualized developmental (NIDCAP) care was not supported by the sleep measures in this study.…”

Neonatal EEG/Sleep State Analyses: A Complex Phenotype of Developmental Neural Plasticity

“…These altered conditions promote longer bouts of wakefulness and a greater percentage of wakeful state over a 24-hour period [38][39][40] . Such an adaptive response consequentially places the child at increased risk for disease through depletion of energy reserves and excessive stimulation of receptive neuronal networks.…”