Effectiveness of Individualized Developmental Care for Low-Risk Preterm Infants: Behavioral and Electrophysiologic Evidence

PEDIATRICS ◽  
1995 ◽  
Vol 96 (5) ◽  
pp. 923-932 ◽  
Author(s):  
Deborah M. Buehler ◽  
Heidelise Als ◽  
Frank H. Duffy ◽  
Gloria B. McAnulty ◽  
Jacqueline Liederman
Keyword(s):  
Frontal Lobe ◽  
Preterm Infants ◽  
Behavioral Assessment ◽  
Special Care ◽  
Full Term ◽  
Low Risk ◽  
Control Group ◽  
Term Infants ◽  
Developmental Care ◽  
Experimental Group

Objective. We assessed the effectiveness of individualized developmental support in the special care nursery for low-risk preterm infants. Setting. A university-affiliated teaching hospital. Participants. Twelve healthy full-term infants, and 24 low-risk preterm infants randomly assigned to a control or an experimental group. Design. The preterm control group received standard care and the preterm experimental group received individualized developmental care at the same special care nursery. Outcome Measures. Medical, behavioral (Assessment of Preterm Infants' Behavior and Prechtl's Neurological Examination of the Full-Term Newborn Infant), and electrophysiologic outcome (using quantitative electroencephalography with topographic mapping) of all three groups was assessed 2 weeks after the expected due date. Results. No between-or among-group medical differences were seen for this low-risk, healthy sample. The preterm experimental group showed behavioral and electrophysiologic performances comparable to those of the full-term group, whereas the preterm control group performed significantly less well. Behavioral measures suggested significantly poorer attentional functioning for the preterm control group. Electrophysiologic results implicated the frontal lobe. Conclusions. Individualized developmental intervention supports neurobehavioral functioning as measured at 2 weeks post-term. It appears to prevent frontal lobe and attentional difficulties in the newborn period, the possible causes of behavioral and scholastic disabilities often seen in low-risk preterm infants at later ages.

scholarly journals Impact of physiotherapy on neuromotor development of premature newborns

2014 ◽  
Vol 27 (3) ◽  
pp. 413-420 ◽  
Author(s):  
Giselle Athayde Xavier Coutinho ◽  
Daniela de Mattos Lemos ◽  
Antônio Prates Caldeira
Keyword(s):  
Preterm Infants ◽  
Motor Development ◽  
Perinatal Care ◽  
Monitoring Program ◽  
Full Term ◽  
Control Group ◽  
Term Infants ◽  
Significance Level ◽  
The Impact ◽  
Neuromotor Development

Introduction The population of children born prematurely has increased in line with improving the quality of perinatal care. It is essential to ensure to these children a healthy development. Objective We evaluate the neuromotor development of a group of preterm infants regularly assisted by a physiotherapy service in comparison to full-term newborns, checking, so the impact of the service. Materials and methods We randomly assigned preterm and full-term infants that formed two distinct groups. The group of preterm infants was inserted into a monitoring program of physiotherapy while the other infants were taken as a control group not receiving any assistance in physiotherapy. The groups were compared using the Alberta Infant Motor Scale (AIMS) at forty-week, four and six months of corrected gestational age and the scores were compared using Student's t-test, assuming a significance level of 5% (p < 0.05). Results The preterm group had significantly lower scores at 40th week compared to the control group, but subsequent scores showed no significant differences between the two groups. Conclusion The timely and adequate stimulation was efficient to promote the motor development of premature infants included in a follow up clinic.

scholarly journals Developmental Features of Corpus Callosum in Children Revealed by MRI

2018 ◽  
Vol 9 (1) ◽  
pp. 37-48 ◽  
Author(s):  
Pavel A. Zykin ◽  
Anatolij N. Yalfimof ◽  
Timofey A. Aleksandrov ◽  
Elena I. Krasnoshchekova ◽  
Lyubov A. Tkachenko ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Corpus Callosum ◽  
Preterm Infants ◽  
Full Term ◽  
Control Group ◽  
Relative Area ◽  
Term Infants ◽  
Mean Values ◽  
Children With Cerebral Palsy ◽  
Developmental Features

With the wide use of magnetic resonance imaging (MRI) in clinical practice, more attention is paid to corpus callosum hypoplasia in children with various central nervous system diseases, including the cerebral palsy. We compared the areas of corpus callosum segments on the mid-sagittal MR images of the children with cerebral palsy and a control group; full-term infants and preterm infants. During the postnatal development, overall callosum area naturally increases, but single segments change differently in both absolute and relative values. In the control group, the relative area of the splenium grew insignificantly, whereas for the genu, it was stable. Children with cerebral palsy also show age-specific growth, but the area of corpus callosum is smaller compared with equal age children in the control group. We found an increased relative area of corpus callosum genu and a decrease of anterior body and splenium in the cerebral palsy group compared with the control group. The kCC index shows higher values in the control group than in any age subgroup of children with cerebral palsy. Mean values for the control group steadily increase with age, whereas in the cerebral palsy group, they remain the same. For every age-specific group, the difference of kCC was statistically significant. Mean kCC index values depend on gestational age and are statistically lower in preterm infants compared with full-term infants. Selective corpus callosum hypoplasia found in the current research could be due to Wallerian degeneration or a decreased number of axons in some of its segments. This could be explained by the disruption of neurogenesis in certain cortical areas. The morphometric index kCC can be used to detect deviations in the corpus callosum structure associated with prematurity and cerebral palsy.

Effects of Brazelton Demonstrations for Mothers on the Development of Preterm Infants

PEDIATRICS ◽  
1981 ◽  
Vol 67 (5) ◽  
pp. 711-714 ◽  
Author(s):  
Susan M. Widmayer ◽  
Tiffany M. Field
Keyword(s):  
Preterm Infants ◽  
Infant Development ◽  
Behavioral Assessment ◽  
Fine Motor ◽  
Control Group ◽  
Face To Face ◽  
Group Assignment ◽  
The Face ◽  
Experimental Group ◽  
Bayley Scales

Thirty healthy preterm infants were rendomly assigned either to a control group or to one of two experimental groups. The mothers of the first experimental group were present during an administration of the Brazelton Neonatal Behavioral Assessment Scale and were asked to complete the Mother's Assessment of the Behavior of Her Infant Scale (MABI) at birth and weekly for four weeks after the discharge of their infants. The mothers of the second experimental group were not present during the administration of the Brazelton scale, but were asked to complete the MABI scale at birth and weekly for the first month after discharge. The mothers of the control infants did not observe administration of the Brazelton scale or complete the MABI scale, but were asked to complete a questionnaire on the developmental milestones of their infants. At 1, 4, and 12 months of age these infants were visited in their homes by teams of researchers blind to the hypothesis of the study and to the group assignment of the infants. The results at 1 month demonstrated that the experimental groups performed more optimally on the Brazelton scale interactive process items. These infants also received superior ratings on the video-taped feeding and face-to-face play sequences. At 4 months the experimental group infants showed better fine motor-adaptive abilities on the Denver Developmental Screening Test than did the control group. In addition, the face-to-face interaction ratings of the two experimental groups were significantly better than were those of the control group. The Bayley Scales of Infant Development were administered when the infants were 12 months corrected age. The infants of the experimental groups received significantly higher scores on the Mental Development Scale. This study suggests that teaching mothers the amazing skills of their newborns on the Brazelton and MABI scales may facilitate early interactions which, in turn, may contribute to early cognitive development.

scholarly journals Neurobehavioral conditions and effects of gender, weight and severity in preterm infants according to the Neonatal Behavioral Assessment Scale

2015 ◽  
Vol 31 (3) ◽  
pp. 818 ◽  
Author(s):  
Alicia Alvarez-Garcia ◽  
Albert Fornieles-Deu ◽  
Carme Costas-Moragas ◽  
Francesc Botet-Mussons
Keyword(s):  
Risk Factor ◽  
Preterm Infants ◽  
Learning Effect ◽  
Behavioral Assessment ◽  
Full Term ◽  
Assessment Scale ◽  
Control Group ◽  
The Social ◽  
Preterm Group ◽  
Preterm Babies

<p>The increasing number of preterm babies in recent years has raised interest in studying the consequences of prematurity as a risk factor. In the present paper, 30 preterm babies (at 40 weeks of gestational age (GA)) were assessed using the Neonatal Behavioral Assessment Scale and the results were compared with those of a control group of 28 full term babies. Moreover, the influence of weight, sex and GA was analyzed considering the Brazelton results in the preterm group.</p><p>The preterm group showed significantly lower scores than the control group for 9 of the 28 behavioral items in the Scale and for 2 of the 5 clusters. However, preterm babies performed better in habituation to disturbing stimuli (light and sound) during sleep. In relation to the influence of sex, premature girls performed better in the Social-Interactive cluster.</p>The preterm group has lower neurobehavioral conditions than the full term group, probably due to the abrupt interruption of their intrauterine maturation. In contrast, they showed a better ability of habituation, maybe as a consequence of a learning effect due to earlier additional extrauterine exposition.

scholarly journals CATAMNESTIC OBSERVATION OF CARDIOVASCULAR STATUS IN PRETERM INFANTS

2018 ◽  
Vol 5 (1) ◽  
pp. 41-45
Author(s):  
M. Gonchar ◽  
A. Boichenko
Keyword(s):  
Diastolic Function ◽  
Preterm Infants ◽  
Myocardial Dysfunction ◽  
Oval Window ◽  
Full Term ◽  
Control Group ◽  
Term Infants ◽  
Heart Ventricles ◽  
Gestation Age ◽  
Term Newborns

CATAMNESTIC OBSERVATION OF CARDIOVASCULAR STATUS IN PRETERM INFANTSM.O. Gonchar, A.D. BoichenkoTo identify peculiarities of the diastolic function development of the heart ventricles in preterm infants following clinical and instrumental examination in the neonatal period and in the process of catamnestic observation the study involved examination of 244 preterm infants at gestation age from 260-7 to 376-7 weeks. Control group comprised 100 healthy full-term infants. The study showed that peculiarities of the development of diastolic function of the heart ventricles in prematurely born children included diastolic dysfunction by the type of delayed relaxation, which is typical for the fetus, until the child reaches the postconceptual age of 39-41 weeks. Normalization of the diastolic function of the heart ventricles occured in 46/61 (75.41 ± 5.51%, p = 0.1·10-6) prematurely born children to 5-6 months of actual age, in 15/61 (24.59 ± 5.51%) children to 6-8 months of actual age. Spontaneous closure of open oval window up to the age of 1 year occurred in 22/32 (68.75 ± 8.19%, p = 0.009) full-term newborns and in 21/61 (34.43 ± 6.08%) preterm infants. Hemodynamically significant patent arterial duct in 58.82 ± 11.94% of children spontaneously closes during the first three months of life. The incidence of myocardial dysfunction in newborns from mothers with extragenital pathology increased to 89.39 ± 3.79% versus 76.67 ± 5.46%, p = 0.046 children born from healthy women. The presence of extragenital pathology in mothers, including cardiovascular disorders, is a risk factor for the development of cardiovascular diseases in preterm children.Key words: preterm infants, myocardial dysfunction, catamnesis.  КАТАМНЕСТИЧНЕ СПОСТЕРЕЖЕННЯ СТАНУ СЕРЦЕВО-СУДИННОЇ СИСТЕМИ У ПЕРЕДЧАСНО НАРОДЖЕНИХ ДІТЕЙГончарь М.О., Бойченко А.Д.З метою визначення особливостей становлення діастолічної функції шлуночків серця у передчасно народжених дітей на підставі клініко-інструментального дослідження в неонатальний період та в процесі катамнестичного спостереження обстежено 244 передчасно народжені дитини зі строком гестації від 26 до 37 тижнів. Контрольна група – 100 здорових доношених новонароджених. За результатами дослідження встановлено, що до особливостей становлення діастолічної функції шлуночків серця у передчасно народжених дітей відноситься реєстрація діастолічної дисфункції за типом уповільненої релаксації, що є характерним для плода, до досягнення дитиною постконцептуального віку 39-41 тиждень. Нормалізація діастолічної функції шлуночків серця відбувається у 46/61 (75,41±5,51%, р=0,1·10-6) передчасно народжених дітей к 5-6 місяцю фактичного віку, у 15/61 (24,59±5,51%) дітей – к 6-8 місяцям фактичного віку. Спонтанне закриття відкритого овального вікна до віку 1 року відбувається у 22/32 (68,75±8,19%, р=0,009) доношених новонароджених та у 21/61 (34,43±6,08%) передчасно народжених дітей. У 58,82±11,94% дітей з гемодинамічно значущою ВАП відбувається її спонтанне закриття на протязі перших трьох місяців життя. Частота зустрічальності міокардіальної дисфункції у новонароджених від матерів з екстрагенітальною патологією зростає до 89,39±3,79% проти 76,67±5,46%, р=0,046 дітей народжених від здорових жінок. Наявність у матерів екстрагенітальної патології, в тому числі патології серцево-судинної системи, є факторами ризику розвитку серцево-судинних розладів у передчасно народжених дітей.Ключові слова: передчасно народжені діти, міокардіальна дисфункція, катамнез. КАТАМНЕСТИЧЕСКОЕ НАБЛЮДЕНИЕ СОСТОЯНИЯ СЕРДЕЧНО-СОСУДИСТОЙ СИСТЕМЫ У НЕДОНОШЕННЫХ ДЕТЕЙГончарь М.А., Бойченко А.Д.С целью определения особенностей становления диастолической функции желудочков сердца у недоношенных детей на основании клинико-инструментального исследования в неонатальный период и в процессе катамнестического наблюдения обследовано 244 преждевременно рожденных ребенка со сроком гестации от 26 до 37 недель. Контрольная группа - 100 здоровых доношенных новорожденных. Установлено, что к особенностям становления диастолической функции желудочков сердца у недоношенных детей относится регистрация диастолической дисфункции по типу замедленной релаксации, что характерно для плода, по достижении ребенком постконцептуального возраста 39-41 недель. Нормализация диастолической функции желудочков сердца отмечается у 46/61 (75,41±5,51%, р=0,1·10-6) недоношенных детей к 5-6 месяцу фактического возраста, у 15/61 (24,59±5,51%) детей – к 6-8 месяцам фактического возраста. Спонтанное закрытие овального окна в возрасте 1 года зарегистрировано у 22/32 (68,75±8,19%, р=0,009) доношенных новорожденных и у 21/61 (34,43±6,08%) недоношенных детей. Спонтанное закрытие гемодинамически значимого ОАП у 58,82±11,94% детей происходит в течение первых трех месяцев жизни. Частота встречаемости миокардиальной дисфункции у новорожденных от матерей с экстрагенитальной патологией возрастает до 89,39±3,79% против 76,67±5,46%, р=0,046 детей рожденных от здоровых женщин. Наличие у матерей экстрагенитальной патологии, в том числе патологии сердечно-сосудистой системы, является факторами риска развития сердечно-сосудистых расстройств у недоношенных детей.Ключевые слова: недоношенные новорожденные, миокардиальная дисфункция, катамнез.

scholarly journals CLINICAL AND GENETIC DETERMINANTS OF PERINATAL PATHOLOGY IN NEWBORNS

2021 ◽  
Vol 21 (3) ◽  
pp. 25-29
Author(s):  
V.I. Pokhylko ◽  
Yu.I. Cherniavska ◽  
S.M. Tsvirenko ◽  
Z.I. Rossokha ◽  
O.V. Yakovenko
Keyword(s):  
Risk Factors ◽  
Preterm Infants ◽  
Glutathione Transferase ◽  
Diastolic Pressure ◽  
Full Term ◽  
Control Group ◽  
Term Infants ◽  
Renin Angiotensin ◽  
Perinatal Pathology ◽  
Gstt1 Genotype

One of the pressing issues of healthcare nowadays is applying methods of molecular genetics aimed at identifying and assessing genetic risk factors and early diagnosis of perinatal pathology. Numerous studies have contributed to identifying risk factors that affect the health of newborns. The aim of this work is to investigate the associations between the development of perinatal pathology in premature and full-term infants with polymorphism of genes of the glutathione transferase family (GSTT1, GSTM1, GSTP1), renin-angiotensin system (ACE, AGT2R1). Materials and methods. The study included 110 full-term infants with asphyxia, 30 healthy full-term infants for the control group, and 125 preterm infants with perinatal infections, 21 preterm infants with broncho-pulmonary dysplasia, and 70 conditionally healthy preterm infants. A set of routine clinical and laboratory methods of research and determining gene polymorphism was performed. Results. The presence of a non-functional allele of the GSTT1 gene and DD variant of the ACE gene in newborns is associated with the development of severe perinatal asphyxia (p = 0.006 and p = 0.003, respectively). Children with GSTT1 "-" and AC AG2TR1 genotypes have significantly higher levels of diastolic pressure in the first day after birth than children with functional genotypes of these genes (p <0.05). The median mean duration of mechanical ventilation and CPAP in children with GSTT1 genotype "-" was significantly higher than that in children with GSTT1 genotype "+" (p = 0.01 and p = 0.001, respectively). Conclusion. Polymorphism studies of glutathione transferase and renin-angiotensin genes can be used to predict the severity of a child's condition after birth.

Infant–Father Attachment in Infants Born Preterm - A Brief Report

2021 ◽  
pp. 1-6
Author(s):  
Ruediger Kissgen ◽  
Sebastian Franke ◽  
Nino Jorjadze ◽  
Bernhard Roth ◽  
Angela Kribs
Keyword(s):  
Preterm Infants ◽  
Full Term ◽  
Strange Situation ◽  
Term Infants ◽  
Attachment Quality ◽  
Attachment Research ◽  
Neurodevelopmental Problems ◽  
Strange Situation Procedure ◽  
Father Attachment

This study examines the infant–father attachment in infants born preterm (<  1500 g at birth and/or <  37 weeks gestation) in comparison to full-term infants. The infant–father attachment was assessed using the Strange Situation Procedure at a (corrected) age of 15 months. We found at least half of preterm and full-term infants (50.0% and 56.5 % respectively) securely attached to their fathers, and no significant overall difference was observed concerning the distribution of attachment quality comparing the two groups. In light of the fact that preterm infants tend to have numerous neurodevelopmental problems, it is encouraging that significant differences were not found in the distribution of the attachment quality among the groups. Therefore, from the perspective of attachment research, it would be highly beneficial to include fathers in the care of their preterm infants.

Olfactory Stimulation of Preterm Infants with Breast Milk

2021 ◽  
pp. 105477382110189
Author(s):  
Woon Ae Lee ◽  
Jin Suk Ra
Keyword(s):  
Breast Milk ◽  
Preterm Infants ◽  
Repeated Measures ◽  
Physiological Responses ◽  
Nursing Intervention ◽  
Olfactory Stimulation ◽  
Control Group ◽  
Repeated Measures Analysis ◽  
Equivalent Control ◽  
Experimental Group

Maintaining stable physiological responses may be important for the growth and development of preterm infants. The purpose of our study was to evaluate the effects of olfactory stimulation with maternal breast milk on the occurrence of abnormal physiological responses in preterm infants. With a non-equivalent control group pretest-posttest design, 13 preterm infants in the experimental group and 18 preterm infants in the control group completed the intervention. The intervention was implemented three times a day for 5 days in a row with 2 hours of administration per intervention. The frequency of abnormal physiological responses was assessed over 6 days (one day before intervention administration and 5 days during intervention administration). With repeated-measures analysis of variance, the experimental group showed a significantly lower frequency of apnea than the control group ( p = .021). Olfactory stimulation with maternal breast milk may be an effective nursing intervention for reducing apnea episodes in preterm infants.

The Effect of Individualized Developmental Care Practices in Preterm Infants

2019 ◽  
Vol 27 (2) ◽  
pp. 97-104
Author(s):  
Dilek Küçük Alemdar ◽  
Sevil İnal
Keyword(s):  
Breast Milk ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Controlled Trial ◽  
Oral Feeding ◽  
Control Group ◽  
Developmental Care ◽  
Significant Difference ◽  
Care Practices ◽  
Maternal Voice

Background: Preterm infants are vulnerable humans requiring much care and attention. They may be exposed to irregular noise, light, and odor in the neonatal intensive care unit for a period of several weeks or months. This study was carried out to determine the effect of individualized developmental care on physiological parameters, growth, and transition to oral feeding in preterm infants. Methods: The study was a randomized controlled trial. The sample comprised premature infants meeting the inclusion criteria. They were randomly assigned to four groups: the maternal voice group, the breast milk odor (BMO) group, the incubator cover (IC) group, and the control group. Results: No statistically significant difference was found between the groups in terms of weight, height, and head circumference at time of discharge. Mean SO2 values were statistically higher in the IC group than the other groups; however, the heart rate and respiratory rate were not statistically different in a significant sense between the groups. The briefest duration of transition to total oral feeding was seen in the BMO group. Conclusion: Individualized developmental care practices based on the results of these interventions are likely to support the care of preterm infants. Breast milk odor may ease the transition to breastfeeding.

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