Stable Individual Differences in Developmentally Changing Preterm Infants: A Replicated Study

Korner, Anneliese F.; Brown, Byron W.; Dimiceli, Sue; Forrest, T. G.; Stevenson, David K.; Lane, Nancy M.; Constantinou, Janet C.; Thom, Valerie A.

doi:10.2307/1130994

Cited by 21 publications

(10 citation statements)

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“…Furthermore, it could have been assumed that our youngest infants were too immature to be able to modulate interacting systems (it has been proposed that independent physiological systems do not become coordinated until about 35-36 weeks gestational age; Nijhuis et al, 1983;Prechtl, Fargel, Weinemann, & Bakker, 1979) and that our oldest infants were beyond the neonatal period and therefore too mature to continue showing the modulatory effects of arousal on attention (Maisel & Karmel, 1978;Ruff & Turkewitz, 1979; and many others have shown transitions in visual preference behavior after about 48-50 weeks postconceptional age). On the other hand, others have reported consistent behavior in infants extending from 1-2 months before term through term age (see Korner et al, 1989, for a discussion of behavioral stability between 32 and 40 weeks postconceptional age; also see Prechtl, 1984;Visser & Prechtl, 1988). Moreover, Prechtl (1984) has noted that with respect to behavior, birth (at 40 weeks) is an arbitrary cutoff and does not represent a major developmental neural break between pre-and postnatal life.…”

Section: Discussionmentioning

confidence: 97%

Arousal/visual preference interactions in high-risk neonates.

Gardner¹,

Karmel²,

Magnano³

1992

Developmental Psychology

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We investigated the organization of arousal and attention processes in 138 neurologically at-risk neonates by studying visual preferences when the infants were in 3 arousal conditions: less aroused (after feeding while swaddled), more aroused-internal (before feeding while unswaddled), and more aroused-external (after feeding while swaddled with 8-Hz visual stimulation before each trial). The stimuli were unpatterned light panels illuminated at temporal frequencies of 1,2,4, and 8 Hz. Four brain insult groups were defined by cranial ultrasonography and brainstem auditory evoked response tests. There were no differences in looking preferences in the 2 more aroused conditions. A previously reported interaction between arousal level and stimulus frequency was replicated, with infants preferring faster frequencies when arousal was decreased. Brain insult reduced this interaction by shifting preference functions when less aroused toward less stimulation.Infants cannot gain information, learn about the world, or interact socially unless they first actively attend to relevant features of their environment. Typically, term infants are born with most of their physiological systems coordinated and well adapted to the immediate environment they are likely to face. This structural and functional organization is evident in the fundamental processes of state modulation and attention to stimulation that are necessary antecedent conditions to learning and memory.For neonates, it appears that arousal and attention work interdependently as a quantitatively organized homeostatic system that combines the effects of internal and external factors to specify attention to particular stimuli. Thus, systematic directional shifts in attention occur when either external or internal factors vary. For example, when infants are more aroused (and have higher levels of internal activity), they orient toward less intense stimuli, and when infants are less aroused (and have lower levels of internal activity), they orient toward more intense stimuli (

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Section: Discussionmentioning

confidence: 97%

Arousal/visual preference interactions in high-risk neonates.

Gardner¹,

Karmel²,

Magnano³

1992

Developmental Psychology

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“…Multiple studies have documented the test-retest reliability, validity, and interobserver reliability. [17][18][19][20][21][22][23][24] The NAPI consists of 27 items that require handling of the infant, 14 behavioral state ratings made prior to and following items that required handling, and 30 summary ratings. The NAPI items are administered in an invariant sequence, halfway between feedings, and take $30 minutes to complete.…”

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confidence: 99%

Neurobehavior of Preterm Infants at 36 Weeks Postconception as a Function of Morphine Analgesia

Rao¹,

Sampers²,

Kronsberg³

et al. 2007

Amer J Perinatol

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This study evaluated early neurobehavioral outcomes in ventilated preterm infants randomized to receive morphine analgesia or placebo in the Neurological Outcomes and Pre-emptive Analgesia in Neonates (NEOPAIN) trial. Eight hundred and ninety-eight infants between 23 and 32 weeks of gestation were randomized to receive preemptive morphine analgesia (morphine) or placebo. Infants also received additional analgesia (AA) with open-label morphine. The Neurobehavioral Assessment of the Preterm Infant (NAPI) was used to evaluate 572 of 793 survivors (72.1%) at 36 weeks of postconceptual age. The Neonatal Medical Index (NMI) was used to evaluate the severity of medical complications. Regression analyses were used to determine the effect of covariates. Infants were equally distributed in morphine and placebo groups with similar neonatal and demographic characteristics. Infants assessed with the NAPI were more likely to have sepsis ( P = 0.03), bronchopulmonary dysplasia ( P = 0.02), and longer length of stay ( P = 0.008). Infants randomized to the morphine group had higher NMI scores (odds ratio [OR]; 95% confidence interval [CI]: 1.75; 1.23 to 2.50; P = 0.002). Use of AA was associated with higher NMI scores (OR; 95% CI: 4.5; 2.9 to 5.9; P < 0.001). Of the NAPI subscales, the (mean +/- standard deviation [SD]) popliteal angle cluster scores were significantly higher in the morphine group compared with placebo (51.2 +/- 33.2 versus 45.0 +/- 33.5; P = 0.03). AA use was associated with lower (mean +/- SD) MOTOR scores in the morphine group (48.2 +/- 16.1 versus 52.7 +/- 19.1; P = 0.03) and with lower POPLITEAL ANGLE cluster scores in both the morphine group (41.5 +/- 34.0 versus 59.5 +/- 30.1; P < 0.0001) and the placebo group (40.8 +/- 36.8 versus 49.4 +/- 28.0; P = 0.004). No differences were noted in the other NAPI subscales cluster scores in either subgroup. We conclude that morphine analgesia may result in subtle neurobehavioral differences in premature infants.

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“…there was no "catch up". A similar stability in individual motor performance in relationship to other individuals seems to occur as early as from gestational week 32 (37).…”

Section: %mentioning

confidence: 72%

Perinatal risk factors and neuromotor behaviour during the neonatal period

Katz‐Salamon

Allert

et al. 1997

Acta Paediatrica

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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,

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Stable Individual Differences in Developmentally Changing Preterm Infants: A Replicated Study

Cited by 21 publications

References 0 publications

Arousal/visual preference interactions in high-risk neonates.

Arousal/visual preference interactions in high-risk neonates.

Neurobehavior of Preterm Infants at 36 Weeks Postconception as a Function of Morphine Analgesia

Perinatal risk factors and neuromotor behaviour during the neonatal period

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