Perinatal risk factors and neuromotor behaviour during the neonatal period

Abstract

Katz-Salamon M, Allert K, Bergstrom B-M, Ericsson K, Hesser U, Forssberg H. Perinatal risk factors and neuromotor behaviour during the neonatal period. Acta Pzdiatr 1997; Suppl419: 27-36. Stockholm. ISSN Preterm birth is associated with an increased risk for neurological handicaps. The purpose of the present study has been: to investigate the influence of perinatal risk factors on early neuromotor development during the neonatal period; to specify the neuromotor parameters particularly sensitive to perinatal complications; and to analyse whether the infant's age at test influences the results. Bedside examination of passive/active muscle tone and automatic movements (22 parameters) was performed at 36 (101 infants) and 40 (153 infants) gestational weeks. Low birthweight and long treatment on a ventilator had a negative influence on the neuromotor behaviour at 36 weeks' gestation and white matter disturbances strongly affected the neuromotor parameters at 40 weeks. The development of rooting, sucking, swallowing and arm recoil after long-lasting ventilator treatment was affected by several neonatal risk factors. The development of passive muscle tone and several parameters measuring active muscle tone demonstrated individual consistency between tests, i.e. an infant's rank at 36 weeks' gestation was unchanged 4 weeks later, and some other parameters were not as consistent. The present study shows that several perinatal risk factors influence neuromotor behaviour already during the neonatal period. In addition, the present study provides data on the neuromotor behaviour during the neonatal period that will be related to later neurodevelopmental examinations in order to evaluate the prognostic value of testing neuromotor development. 0 Neuromotor development, premature infants M Katz-Salamon, Neonatal and Reproduction Laboratory C4U1, Karolinsku Hospital, S-I71 76 Stockholm,

Stability of longitudinal motor development in very low birthweight infants from 5 months to 5.5 years

“…The results of the neonatal assessments at 36 and 40 wk of gestation were presented elsewhere (17). As the number of VLBW infants taking part in the examination at 3 y of age was low (n = 133) the results of this motor examination were excluded from the present analysis.…”

Desempenho motor em recém-nascidos pré-termo de alto risco

“…Existem três grupos de indicadores de risco para déficit motor sendo eles: risco biológico onde são incluídos RN com peso de nascimento < 1500 gramas, idade gestacional < 32 semanas, ventilação mecânica por mais de 36 horas, hemorragia peri-intraventricular graus III e IV, anormalidades do tônus muscular, Apgar < 5 no 5 o minuto e infecções congênitas; risco estabelecido que são RN portadores de hidrocefalia, microcefalia, anormalidades cromossômicas, anormalidades músculo-esqueléticas, miopatias congênitas e infecção por HIV; e por último os RNs incluídos no grupo de risco sócio-ambiental aonde apresentam alto risco social, abuso materno de drogas e/ou álcool e anormalidades no estado comportamental 5,6 .…”

Resuscitation and ventilation strategies for extremely preterm infants: a comparison study between two neonatal centers in Boston and Stockholm

“…In the very immature infant, a new broncho‐pulmonary dysplasia, (BPD), related to early oxygen and ventilatory exposure with the first breath of life has been described (4,5). BPD and long periods of mechanical ventilation (MV) are associated with an increased neurodevelopmental morbidity suggesting that minimizing the development of BPD in this population could have positive effects on outcome (6,7).…”

“…Only 24% of the infants received MV from the beginning and 51% of infants received early CPAP. The low BPD rate (14%) and the positive correlation found between the duration of MV and a poor neurological outcome, suggested that CPAP contributed to a more desirable outcome (7,10). Van Marter et al recently compared two neonatal units and found the incidence of BPD to vary from 4% to 22% in infants born with birth weights <1500 grams (11).…”