Sex Differences in High-Risk Premature Infants' Asymmetric Movement Development

Abstract

High-risk premature infants are likely to show altered patterns in the development of reflexes and postural reactions. This study used the Modified-Measure of Behavioral Laterality (M-MOBL) neonatal assessment to explore differences in reflex and postural reactions among 26 male and female high-risk, premature infants born between 23 and 26 weeks gestational age. M-MOBL scores at 33-36.5 weeks were compared to those at 36.5-40 weeks of age, shortly before hospital discharge. The M-MOBL data were analyzed using the categorical method (CATMOD) repeated measures analysis of variance (ANOVAs) to compare the development of asymmetric movement patterns in: (1) non-injured and CNS-injured high-risk, premature infants, (2) control and experimental infants who received multi-sensory stimulation, and (3) male and female infants. Consistent with previously published reports of a right-(R) bias for healthy, full-term infants' movements, we found that high-risk premature females showed Rsided biases by 35-37 weeks post-conceptional age (PCA) for head turning responses and reflexes evoked by upper-body stimulation (i.e., palmar grasp, asymmetric tonic neck reflex [ATNR], incurvation). High-risk premature males, however, showed no significant difference in strength and coordination between the R-side and the left (L), as measured by the M-MOBL, in most of these upper-body movements tested at 35-37 weeks PCA. Neither premature males nor females showed asymmetries in foot and leg reflexes (placing, plantar grasp, Babinski). Healthy, full-term males did not show asymmetries in these reflexes either. However, full-term females showed R-bias. With further research, the M-MOBL may become a useful instrument for early identification of infants with atypical CNS development who later exhibit atypical laterality patterns.