STATE, POSTURE AND MOTOR ACTIVITY IN THE VERY LOW BIRTH WEIGHT NEONATE

Abstract

Eleven preterm infants with gestational age (GA) ranging from 24 to 34 weeks were observed during the neonatal period to determine state, posture, quantity and quality of motor activity, and any effect of ventilatory assistance (VA) upon these functions for the 7 VA infants in the group. Infants were observed for a 10 minute period at a specific time daily during the first week, then weekly throughout the nursery course. State was determined using Brazelton grading. Posture was recorded at the beginning of the observation. All movements of head, eyes, body and limbs were recorded according to defined categories. The predominant behavioral states observed were light sleep and dozing. No specific preference for body and/or limb posture was observed. All infants had frequent twitches and movements predominantly of the limbs which produced posture changes. Quantity of movements did not follow any particular patterns. However, a marked change in quantity of movements was usually associated with sedation and/or illness. Clonus and tremors were almost always seen in the ventilatory assisted infant, and rarely the non-respirator infants. Posture as well as quantity and quality of movements was not related to GA or conceptual age (CA). In conclusion, the serial and systematic observation of motor activity in the preterm infant confirms the time honored clinical observation that changes in motor activity may herald significant illness. In spite of previous work by others, in this group of preterm infants posture preference did not relate to GA or CA.