Neurobehavioral Functioning of Healthy Preterm Infants of Varying Gestational Ages

Abstract

Little information is available regarding the behavioral repertoire of healthy, yet prematurely born, infants. To address this problem, the Assessment of Preterm Infants' Behavior (APIB) was used 10 to 14 days after birth in a cross-sectional comparison of 42 healthy newborn infants: 16 full-term infants (gestational age at birth [GA] = 40 weeks), 13 close to full-term infants (GA = 37 weeks), and 13 preterm infants (GA = 34 weeks). Groups differed on four background variables that were used as covariates in subsequent analyses. Significant group differences were found on 12 of 29 outcome variables, including measures of autonomic, motor, state, attention/interaction, and self-regulatory systems, as well as a measure of overall behavioral organization. Pairwise comparison showed that preterm and full-term infants differed on all 12 variables whereas preterm and close to full-term infants differed on 11 of the 12 variables. Furthermore, full-term and close to full-term infants differed on 4 of the 12 variables, including measures of the autonomic, motor, and state systems. Full-term and close to full-term infants were behaviorally more similar to one another than either group was to the preterm infants, yet there were important differences even between full-term and close to full-term infants.

The Assessment of Preterm Infants' Behavior (APIB): Furthering the understanding and measurement of neurodevelopmental competence in preterm and full‐term infants

“…The APIB shows highly significant detection of cross-sectionally assessed developmental differences between medically low-risk infants at varying gestational ages at birth (34, 37, and 40 weeks) [Mouradian, Als, and Coster, 2000], thus providing significant implications for clinical care and support. Significant longitudinal developmental changes were identified in a study of healthy full-term and preterm infants assessed at 40 and 44 weeks' postmenstrual age; thus demonstrating high test-retest reliability of the APIB [Als, Duffy, and McAnulty, 1988b].…”

The Effect of Skin-to-Skin Contact (Kangaroo Care) Shortly After Birth on the Neurobehavioral Responses of the Term Newborn: A Randomized, Controlled Trial

“…Extensor movements have been demonstrated to indicate less mature CNS control and are observed frequently in preterm infants. 61,62 Their relative disappearance in well-developing, term infants is considered an index of CNS maturation. This index has been variously demonstrated to be brain based and associated with distinct patterns of visual evoked responses during extensor movements at term, which were found to decrease as a function of gestational ages at birth.…”

“…The results of the study support those of others who found that KC effects decrease the amount of purposeless movements 64 and that developmental care reduces the degree and amount of extensor responses. [61][62]65 In addition, the contribution of KC in lowering the stress experienced postpartum seems to be reflected specifically by the increase in active flexor motor responses. This suggestion is in line with the findings of lower levels of cortisol after touch treatment 66 and more extended movements as an expression of pain during invasive procedures likely to evoke distress.…”

Kangaroo mother care and mother-premature infant dyadic interaction

“…When babies are born prematurely, the discrepancy between mothers' representations of their children during pregnancy and the reality of the situation at birth can be dramatic. Several studies have revealed behavioral repertoire differences between full-term and healthy preterm infants on measures of autonomic, motor, state, attention/interaction, and self-regulatory systems as well as on overall behavioural organization ͑Minde, 2000; Mouradian, Als, & Coster, 2000͒. For instance, premature infants are not as ready to receive and respond to social stimuli as are full-term babies, and their behavior is often ambiguous and disorganized and therefore frequently difficult for adults to interpret ͑Goldberg, 1979͒.…”