Motor Development Of Preterm Infants Research Articles

The Comparison of Three Assessment Scales in a Neonatal Unit in Poland

Abstract The aim of this study was to analyse the relationship between the following three assessments: the Neonatal Behavioral Assessment Scale (NBAS), the Alberta Infant Motor Scale (AIMS), and the General Movement Assessment (GMA). 29 patients from the neonatal unit of the Gynecology and Obstetrics Clinical Hospital were examined. The study was conducted between feedings by a person properly trained in the use of the NBAS, the AIMS, and the GMA. The average postmenstrual age of the examined newborns was 35.6 weeks. The average week of gestation was the 29th, the average birth weight was 1469 g, and the Median Apgar score in the fifth minute of life was 7. A relationship was found between the AIMS and the NBAS. It was concluded that the Neonatal Behavioral Assessment Scale and the Alberta Infant Motor Scale may be used to determine the motor development of preterm infants. Moreover, it is advisable to use more than one assessment method in order to adjust the intervention.

Influencia del nivel de riesgo perinatal sobre el desarrollo motor grueso de los niños prematuros: Estudio observacional de corte transversal

La prematuridad es uno de los principales problemas de la sanidad perinatal; teniendo en cuenta su elevada incidencia, la morbilidad mostrada a corto y largo plazo, y la escasa evidencia científica que determine la influencia que los factores de riesgo tienen sobre el desarrollo motor en prematuros, nos planteamos realizar un estudio que analizara la influencia que los factores de riesgo perinatales tienen sobre la motricidad gruesa de esta población. El método es un estudio observacional de corte transversal sobre una muestra de 261 prematuros, evaluados desde noviembre de 2014 hasta abril de 2018. Se utilizó la Escala de Desarrollo Motor Infantil de Alberta (AIMS), para comprobar el nivel de desarrollo motor grueso, el percentil en el cual se encuentra el prematuro, y el Inventario de Riesgo Perinatal (PERI) para determinar la puntuación y el nivel de riesgo perinatal. Los resultados encontrados han sido: se muestra una relación significativa e inversa entre el riesgo perinatal y la motricidad gruesa, en ambos sexos (p = 0.000). Por tanto, el desarrollo motor grueso de los niños prematuros es menor conforme aumenta el nivel de riesgo perinatal. La hemorragia intracraneal y la edad gestacional son los factores de riesgo perinatales que mayor influencia han mostrado sobre el desarrollo motor grueso de los niños prematuros.

Transient structural MRI patterns correlate with the motor functions in preterm infants

AimTo explore the relationships between transient structural brain patterns on MRI at preterm and at term-equivalent age (TEA) as a predictor of general movements (GMs) and motor development at 1-year corrected age (CA) in very preterm infants. MethodsIn this prospective study, 30 very preterm infants (median = 28wks; 16 males) had structural magnetic resonance imaging (MRI) at preterm (median = 31wks + 6d) and at TEA (median = 40wks) and neuromotor assessments. The quality of GMs was assessed by Prechtl’s general movements assessment and a detailed analysis of the motor repertoire was performed by calculating a motor optimality score (MOS), both at term age and at 3 months post-term. Motor development at 1-year CA was evaluated with the Infant Motor Profile (IMP). Associations between qualitative MRI findings and neuromotor scores were investigated. ResultsAbnormal GMs and low motor performance at 1-year CA were associated with the poor visibility of transient structural pattern, that is with sagittal strata. InterpretationTransient structural MRI pattern, sagittal strata, at preterm age is related to the quality of GMs and later motor development in preterm infants. This transient fetal brain compartment may be considered as a component of neurobiological basis for early neuromotor behavior, as expressed by GMs.

The Coping with and Caring for Infants with Special Needs intervention was associated with improved motor development in preterm infants.

AimWe compared the impact of standard infant physiotherapy and the family‐centred programme, Coping with and Caring for Infants with Special Needs (COPCA), in infants born before 32 weeks without significant brain lesions.MethodsThis randomised controlled trial was carried out in patients' homes and outpatient settings in Switzerland between January 2016 and October 2019. We used data from the national SwissNeoNet register and an assessment battery that included infant and family outcomes and video analyses of therapy sessions. The Infant Motor Profile was the primary outcome instrument.ResultsThe COPCA group comprised six boys and two girls with a median gestational age of 27 weeks (range 25‐30), and the standard care group comprised seven boys and one girl with a median gestational age of 29.5 weeks (range 26‐31). COPCA participants improved significantly more between baseline and 18 months in the IMP variation (9.0 percentage points, 95% confidence interval: 0.3‐17.5) and performance (12.0 percentage points, 95% confidence interval: 4.1‐20.6) domains than standard care participants. COPCA coaching was positively associated with IMP scores at 18 months, but some standard care actions were negatively associated.ConclusionCOPCA was associated with better motor outcome in infants born before 32 weeks than standard infant physiotherapy.

Do NICU developmental care improve cognitive and motor outcomes for preterm infants? A systematic review and meta-analysis

BackgroundThe aim of this study was to review the effects of developmental care in neonatal intensive care unit (NICU) setting on mental and motor development of preterm infants.MethodWe searched PubMed, EMBASE, CINAHL, Scopus, Web of Science and Cochrane library until October 8th 2017, and included randomized controlled trials that assessed effects of developmental care in NICU on mental and motor development of preterm infants at 12 and 24 months of age, using the Bayley scale of infant development in this systematic review. In addition, data were pooled by random effects model and Standardized Mean Difference (SMD) with 95% confidence intervals (CI), calculated for meta-analysis.ResultsTwenty one studies were eligible to be included in this systematic review; however, only thirteen studies had data suitable for meta-analysis. According to statistical analysis, developmental care in NICU improved mental developmental index (MDI) (standardized mean difference [SMD] 0.55, 95% confidence interval [CI] 0.23–0.87; p < 0.05), and psychomotor developmental index (PDI) (SMD 0.33, [CI] 95% CI 0.08–0.57; p < 0.05) of BSID at 12 months of age and PDI at 24 months of age (SMD 0.15, 95% CI -0.02–0.32; p < 0.1) of preterm infants. However, the benefit was not detected at 24 months of age on MDI (SMD 0.15, 95% CI -0.05–0.35; p = 0.15).ConclusionCurrent evidence suggests that developmental care in only NICU setting could have significant effect on mental and motor development of preterm infants, especially at 12 months of age. However, because of clinical heterogeneity, more studies are needed to evaluate the effects of developmental NICU care in the development of preterm infants.

Avaliação do desenvolvimento motor de recém-nascidos prematuros extremos e moderados em uma unidade de terapia intensiva neonatal

Objetivo: avaliar o desenvolvimento motor de recém nascidos prematuros extremos e comparar ao desenvolvimento motor dos recém-nascidos prematuros moderados, em uma UTI Neonatal. Métodos: estudo transversal onde foram avaliados 16 neonatos, cinco prematuros extremos e 11 prematuros moderados, classificados pelo Test of Infant Motor Performance. Resultados: Não houve diferença significativa no desempenho motor entre o grupo de prematuros extremos e moderados, entretanto, a prematuridade extrema reduziu 4,74 pontos no escore. Na correlação entre os fatores de risco e o desenvolvimento motor, o uso de ventilação mecânica não invasiva e o Apgar no 1º minuto foram associados estatisticamente com o desempenho motor atípico. As demais variáveis não apresentaram correlação significativa com o desenvolvimento motor. Conclusão: não houve associação entre a idade gestacional e o desenvolvimento motor de neonatos prematuros.

Associations between Household Incense Burning and Motor Development of Preterm Infants: Results from the Taiwan Birth Cohort Study with Propensity Score Weighting Analysis

Background: Household incense burning is a common ritual behavior in Taiwan, but was found to be associated with negative neurodevelopmental outcomes in term infants. We further examined the associations between exposure status and neurodevelopmental development among preterm infants. Methods: We extracted the information from structured questionnaires upon home interview during six and eighteen months of Taiwan Birth Cohort Study (TBCS) survey. We conducted multivariate Cox proportional hazards to model the association between household exposure status and the corrected age for infant neurodevelopmental milestone achievements and we further weighted the effect with multinomial propensity score (PS). The effect among late preterm infants (gestational age 34-36 weeks) were examined with stratified analysis. Results: In this study, 1062 preterm singletons were included, and 933 of them were late preterm. Household incense burning exposure was associated with increased hazards of delay in gross motor neurodevelopmental milestones (aHR=1⋅19, 95% CI=1⋅01-1⋅41 for walking steadily), and the effects were also observed after PS-weighting (Persistent exposure: aHR=1⋅20, 95% CI=1⋅01-1⋅42 for walking with support; aHR=1⋅25, 95% CI=1⋅05-1⋅48 for walking steadily). Similar effects in gross motor neurodevelopmental milestones were observed among late preterm infants, while the effects for other preterm infants were observed in fine motor neurodevelopmental milestones. Conclusions: This study shows negative associations between household incense burning and delayed motor neurodevelopmental milestone achievement. The effects were shown in different domains for late preterm infants and earlier preterm infants. Funding Statement: Bureau of Health Promotion, Department of Health, Ministry of Science and Technology and Ministry of Education, Taiwan. Declaration of Interests: No conflicts of interest have been declared. Ethical Approval Statement: All subjects in this study provided informed consent according to the protocol approved by the institutional Ethics Review Board of the College of Public Health, National Taiwan University and the Institutional Review Board of the Bureau of Health Promotion, Ministry of Health and Welfare, Executive Yuan, Taiwan, which was in comply with the principles of the Declaration of Helsinki.

Factors Associated with Low Muscle Tone and Impact of Common Musculoskeletal Problems on Motor Development in Preterm Infants at One Year of Corrected Age

Factors Associated with Low Muscle Tone and Impact of Common Musculoskeletal Problems on Motor Development in Preterm Infants at One Year of Corrected Age

Safety and early curative efficacy of lipocyte bioactive secretion in preventing white matter injury of premature infants

Objective To explore the safety and efficacy of intrathecal administration of adipose stem cells derived from bioactive secretome (ASCBS) in treatment of whiter matter injury (WMI) in the preterm infants. Methods Sixty-three cases of WMI were recruited according to the uniform standards from multiple medical centers and they were divided into 3 gestational age (GA) subgroups, which were 21 cases in group A (GA 24-28+ 6), 20 cases in group B (GA 29-32+ 6), and 22 cases in group C (GA 33-36+ 6). The patients were randomly divided into treatment groups and control groups by tossing coins.The treatment groups received lumbar puncture followed with ASCBS intra-thecal injection once daily for 3 consecutive days.Follow-up study included Neonatal Behavioral Neurological Assessment (NBNA) at term-equivalent age and neurodevelopment at corrected age of 6-month.Neurodevelopment was assessed by using the Bayley Scales of Infant Development and Peabody Developmental Motor Scale.The survival rates, NBNA scores, mental development index (MDI), psychomotor develop index (PDI), total motor development quotient, gross motor development quotient and fine motor development among each subgroup were compared. Results Sixty-three cases were recruited, including 31 in the treatment group and 32 in the control group.Only 1 case in the treatment groups lost in the follow-up.No clinical side effects were found in the treatment groups.There was no significant diffe-rence in the survival rate and complication in the preterms in all subgroups of the treatment group and control group (all P>0.05). The gross and total motor development quotient in the treatment group A was higher than that in the control group A(gross motor development quotient: 98.330±6.282 in treatment group A, 90.330±3.777 in control group A, P=0.040; total motor development quotient: 97.330±4.803 in treatment group A, 91.000±4.472 in control group A, P=0.023). The rest findings showed no significant difference between groups. Conclusion The treatment of WMI in preterm infants with ASCBS is safe and can promote the motor development of preterm infants with GA in 24 -28 weeks. Key words: Stem cells; Infant, premature; White matter injury; Lipid stem cells bioactive secretion

Spontaneous movements of preterm infants is associated with outcome of gross motor development

AimsWe conducted a longitudinal cohort study to analyze the relationship between outcome of gross motor development in preterm infants and factors that might affect their development. MethodsPreterm infants with a birth weight of <1500 g were recruited. We measured spontaneous antigravity limbs movements by 3D motion capture system at 3 months corrected age. Gross motor developmental outcomes at 6 and 12 months corrected age were evaluated using the Alberta Infant Motor Scale (AIMS). Statistical analysis was carried out by canonical correlation analysis. ResultsEighteen preterm infants were included. In the 6 months corrected age analysis, spontaneous movement had a major effect on Prone and Sitting at 6 months corrected age of AIMS. In the 12 months corrected age analysis, spontaneous movement had a major effect on Sitting and Standing at 12 months corrected age of AIMS. ConclusionsIn preterm infants, better antigravity spontaneous movements at 3 months corrected age were significantly correlated with better gross motor development at 6 or 12 months corrected age.

Correlation of Birth Weight, Gestational Age and Muscle Tone with Motor Development of Preterm Infants

Correlation of Birth Weight, Gestational Age and Muscle Tone with Motor Development of Preterm Infants

Investigation of the Relationship Between Sensory Processing and Motor Development in Preterm Infants.

The aim of this study was to analyze the correlation between sensory processing and motor development in preterm infants. We included 30 preterm and 30 term infants with corrected and chronological ages between 10 and 12 mo. We used the Test of Sensory Functions in Infants to evaluate sensory processing and the Alberta Infant Motor Scale to evaluate motor development. The Spearman correlation test indicated a strong positive relationship between sensory processing and motor development in preterm infants (r = .63, p < .001). Given the relationship between sensory processing and motor development in the preterm group, the evaluation of sensory processing and motor development in preterm infants was considered necessary for the effective implementation of physiotherapy assessment and interventions.

Predictive models of early motor development in preterm infants: a longitudinal-prospective study

Introduction: Preterm infants are vulnerable to developmental delays. Detecting problems at an early age is one of the challenges of professionals and researchers in the area.Objectives: To analyse the motor development and to identify the risk factors associated with predictors of overall and motor delay in preterm newborns.Methods: Eighty preterm infants (50% female; mean gestational age = 33 ± 2.2 weeks) with low birth weight (average of 1,715 ± 437 g) were evaluated using the Neurobehavioral Assessment of the Preterm Infant (NAPI) during the neonatal phase (prior to term age), the Denver Developmental Screening Test II (DDST-II) between 2 and 8 months, the Test of Infant Motor Performance between 2 and 4 months regarding motor development and the Alberta Infant Motor Scale between 4 and 8 months. Results: Neurobehavioural delay was noted in 24% of the infants in the neonatal phase. Between 2 and 8 months, the delay in overall development was ≥ 31% and the delay in motor development was 35–36 %. Decreased levels of alertness, orientation, motor developmentand vigouraccording to theNAPIwereshown to be predictive of a delay indevelopment between4 and 6 months of age.The delayin overall development between 2 and 6 months was predictive of a delay in motor development between6 and 8months. Conclusion: Neurobehavioural variables, hospital stayandoverall delayare goodpredictorsof motor developmentduring the first yearof age.

Functional variation of SHP-2 promoter is associated with preterm birth and delayed myelination and motor development in preterm infants

Src homology 2 domain-containing protein tyrosine phosphatase 2 (SHP-2) is a cytoplasmic tyrosine phosphatase that is highly expressed in hematopoietic cells and in the CNS and exerts opposite effects on signal transduction by exerting a neuroprotective or proapoptotic effect. Several mutations of SHP-2 have been found in children with myeloproliferative disorders or malignant leukemia, and some of these can affect brain development. In the present study, we aimed to identify and functionally characterize genetic variations in SHP-2 in 72 preterm and 58 full-term infants and to evaluate the effect of the variations on neurodevelopment in preterm infants. Twelve genetic variations were identified. Among them, two variations in the SHP-2 promoter, g.-317C > T and g.-273G > A, were found to significantly increase promoter activity, and the frequency of g.-273G > A was higher in preterm infants than in full-term infants. Two transcription factors, NF-κB and GABPα, were found to be involved in the transcriptional regulation of SHP-2 by the two above-mentioned variations. In particular, we found that g.-273G > A was significantly associated with delayed myelination and poor motor development in preterm infants. Our results suggest that a functional promoter variation in SHP-2 is associated with spontaneous preterm birth itself as well as white matter myelination and neurodevelopment.

Concurrent validity of the Alberta Infant Motor Scale to detect delayed gross motor development in preterm infants: A comparative study with the Bayley III

ABSTRACTObjective: To investigate the concurrent validity of AIMS in relation to the gross motor subtest of the Bayley Scale III/GM in preterm infants. Methods: A total of 159 gross motor development assessments were performed with the AIMS and Bayley-III/GM. Linear regression was used to assess the correlation between AIMS and Bayley-III/GM scores. The intra-class correlation coefficient (ICC) and the Bland-Altman plot were used to analyze intra- and inter-rater reliability. Results: There was a prevalence of delayed gross motor development of 20.8% according to the Bayley-III/GM, and 11.9% for the 5th percentile and 21.4% for the 10th percentile of AIMS. A good correlation of AIMS with Bayley-III/GM scores and intra- and inter-rater reliability was encountered in this study. Conclusion: AIMS proved very capable of detecting delayed gross motor development in preterm infants when compared with the Bayley-III/GM. The 10th percentile of AIMS provided the best combination of indicators, with greater specificity.

Effect of Neuro-Development Treatment on motor development in preterm infants.

[Purpose] To investigate the effects of Neuro-Development Treatment on development in the preterm infants. [Subjects and Methods] A total of 96 premature infants were recruited for this study; 62 low birth weight preterm infants (<2.5 kg, high risk infants for developmental delay) and 34 premature infants (>2.5 kg, low risk infants for developmental delay). High risk infants were divided into intervention group (32 infants) and control group (30 infants) at time of admission. Low risk infants were into comparative group (34 infants). All infants received general nursing care in Neonatal Intensive Care Unit. Additionally, Intervention group received Neuro-Development Treatment for 15 minutes 4 times per week up to 40 week postconceptional age. We evaluated Test of Infant Movement Performance at baseline, 2 weeks after and 40 week postconceptional age. [Results] In score on Test of Infant Movement Performance there was more increase in intervention group than in control group and comparative group. [Conclusion] According to findings in this study, we find that Neuro-Development Treatment in Neonatal Intensive Care Unit has an effect on development in the preterm infants.

Motor Development Interventions for Preterm Infants: A Systematic Review and Meta-analysis.

Preterm infants are at an increased risk of neurodevelopmental delay. Some studies report positive intervention effects on motor outcomes, but it is currently unclear which motor activities are most effective in the short and longer term. The aim of the study was to identify interventions that improve the motor development of preterm infants. An a priori protocol was agreed upon. Seventeen electronic databases from 1980 to April 2015 and gray literature sources were searched. Three reviewers screened the articles. The outcome of interest was motor skills assessment scores. All data collection and risk of bias assessments were agreed upon by the 3 reviewers. Forty-two publications, which reported results from 36 trials (25 randomized controlled trials and 11 nonrandomized studies) with a total of 3484 infants, met the inclusion criteria. A meta-analysis was conducted by using standardized mean differences on 21 studies, with positive effects found at 3 months (mean 1.37; confidence interval 0.48-2.27), 6 months (0.34; 0.11-0.57), 12 months (0.73; 0.20-1.26), and 24 months (0.28; 0.07-0.49). At 3 months, there was a large and significant effect size for motor-specific interventions (2.00; 0.28-3.72) but not generic interventions (0.33; -0.03 to -0.69). Studies were not excluded on the basis of quality; therefore, heterogeneity was significant and the random-effects model was used. Incomplete or inconsistent reporting of outcome measures limited the data available for meta-analysis beyond 24 months. A positive intervention effect on motor skills appears to be present up to 24 months' corrected age. There is some evidence at 3 months that interventions with specific motor components are most effective.

Motor development and sensory processing: A comparative study between preterm and term infants.

To evaluate the sensory processing and motor development in preterm infants aged 4-6 months and compare performance data with their peers born at term. This was a cross-sectional and comparative study consisting of a group of preterm infants (n=15) and a group of term infants (n=15), assessed using the Test of Sensory Functions in Infants (TSFI) and the Alberta Infant Motor Scale (AIMS). The results showed no significant association between motor performance on the AIMS scale (total score) and sensory processing in the TSFI (total score). However, all infants who scored abnormal in the total TSFI score, subdomain 1, and subdomain 5 presented motor performance at or below the 5th percentile on the AIMS scale. Since all infants who presented definite alteration in tolerating tactile deep pressure and poor postural control are at risk of delayed gross motor development, there may be peculiarities not detected by the tests used that seem to establish some relationship between sensory processing and motor development.

Accuracy of the Alberta Infant Motor Scale (AIMS) to detect developmental delay of gross motor skills in preterm infants: A systematic review

Objective: To assess, through a systematic review, the ability of Alberta Infant Motor Scale (AIMS) to diagnose delayed motor development in preterm infants. Methods: Systematic searches identified five studies meeting inclusion criteria. These studies were evaluated in terms of: participants’ characteristics, main results and risk of bias. The risk of bias was assessed with the Quality Assessment of Diagnostic Accuracy Studies – second edition (QUADAS-2). Results: All five studies included a high risk of bias in at least one of the assessed fields. The most frequent biases included were presented in patient selection and lost follow up. All studies used the Pearson correlation coefficient to assess the diagnostic capability of the Alberta Infant Motor Scale. None of the assessed studies used psychometric measures to analyze the data. Conclusion: Given the evidence, the research supporting the ability of Alberta Infant Motor Scale to diagnose delayed motor development in preterm infants presents limitations. Further studies are suggested in order to avoid the above-mentioned biases to assess the Alberta Infant Motor Scale accuracy in preterm babies.

Comparison of the motor development in preterm infants from two brazilian regional samples

Objective: The present study sought to compare the motor development of the preterm infants of two Brazilian regional samples, using a reliable scale evaluation to determine the influence that the environment can have on infants exposed to perinatal conditions and similar risk factors. Materials and Methods: Two cross-sectional samples of preterm low-birthweight infants were used: a study group (SG = 70) and a control group (CG = 43). The assessment tool used was the Alberta Infant Motor Scale (AIMS). Results: There were no statistically significant differences in total score on the AIMS, although some differences were noted in the gestational age variable (at 2, 3 and 4 months of age) and the birth weight variable (weight slightly above that of the CG) among infants. There was also a difference in the classification of motor development at 2 and 3 months of age corrected in accordance with the standard scale, on which the SG was ranked as behindhand in relation to the CG. Conclusion: The results suggest that preterm infants from different regions show the same rate of progress in their motor development, even when subject to different environmental influences. It is, further, suggested that this study should be extended so as to permit a more detailed control of the environment (including the maternal practices) in which the infant is being brought up.