Study documents preemies' development in NICU, suggests early interventions
A study led by Bobbi Pineda, PhD, above, has documented the developmental differences between premature babies in the NICU and full-term babies. The research points to opportunities to intervene in the NICU, to improve preemies’ long-term outcomes. Credit: Robert Boston
(Medical Xpress)—Premature infants are born into a world their tiny bodies often are not ready for. Developmental differences between those babies and full-term infants often are apparent prior to a preemie's discharge from the neonatal intensive care unit (NICU), researchers at Washington University School of Medicine in St. Louis have documented.
Their study points to opportunities for therapeutic interventions—even in the first few weeks of life—to improve premature babies' long-term outcomes.
The research, which focused on infants born at least 10 weeks early, is available online and will appear in an upcoming issue of the Journal of Pediatrics.
"We found that by the time premature infants are at or near their original due dates, they have significant developmental differences compared to full-term infants," says first author Bobbi Pineda, PhD, research assistant professor in Washington University's Program in Occupational Therapy.
The study reports on 75 premature infants at St. Louis Children's Hospital who were evaluated in the NICU at 34 weeks gestation and again at 40 weeks, the length of a full-term pregnancy. The babies also received an MRI to detect brain injuries that could be related to premature birth.
Comparing the preemies to full-term babies, researchers found major differences in muscle tone, reflexes, stress levels, the ability to be soothed and handled by caregivers and the ability to visually track objects and people in the NICU.
Pineda says one of the biggest differences involved the fact that premature babies typically have low muscle tone early in development.
"Full-term babies tuck in their legs and arms close to the body, and they tend to stay like that much of the time for several weeks after birth," Pineda explains. "But premature infants tend to have lower muscle tone, making them more likely to assume an extended position while they are in the NICU."
The flexed position that is assumed at birth is supported by the cramped uterine environment in the final trimester of pregnancy. However, when infants are born early, they miss this experience and the brain has not yet matured to the point that it can signal the infant's muscles to become flexed. Pineda says that the extended positioning in the NICU can interfere with the babies' ability to calm themselves and to coordinate movements smoothly.
"Low muscle tone can be an extra challenge to overcome in order to achieve normal developmental motor skills, like rolling over, sitting up and crawling in the first year of life," she explains.
Typically, premature infants are released from the hospital when they can stay warm without an incubator, be fed by mouth and are able to breathe well without supplemental oxygen, Pineda says.
But she suggests interventions in the NICU may help them catch up with full-term babies who have had more time to develop and grow in utero. For example, more intensive physical and occupational therapy might help babies get stronger before they are discharged from the hospital, and she says it's important that the therapy continues when the babies go home.
"Even when critical medical problems are resolved, our results suggest it's important to continue with physical, occupational and speech therapy," Pineda says. "There are such drastic changes in the first year of life, and now we know that in preemies those changes begin to occur even before their due date. That presents a great opportunity to intervene and to help these babies grow so they can make the same milestones as their full-term peers and reach their full potential."
Pineda is continuing to work with premature babies as part of a large study funded by the National Institutes of Health (NIH). Terrie E. Inder, MD, professor of pediatrics, is the study's principal investigator. Those babies will return for follow-up testing at 2, 4 and 6 years of age.
Testing the babies over time can help determine whether therapies and interventions have helped them get on a normal developmental path or if differences between premature babies and their full-term counterparts continue to linger into early childhood.
"Those follow-ups will give us valuable information about how different interventions may influence a baby's developmental trajectory," Pineda says. "We need to learn what to expect at specific time points, even in premature babies, because that will tell us when babies are on target or whether they may need more intensive interventions to catch up."
More information: Pineda RG, Tjoeng H, Vavasseur C, Kidokoro H, Neil J, Inder T. Patterns of altered neurobehavior in preterm infants within the NICU. Journal of Pediatrics, vol. 161, published on line Oct. 2012, dx.doi.org/10.1016… .2012.08.011
Journal reference: Journal of Pediatrics
- Surviving premature babies in Malawi continue to have poor growth rates and development delay Nov 08, 2011 | not rated yet | 0
- Survival rates for premature babies in high-level NICUs are better than previously reported Jul 23, 2012 | not rated yet | 0
- Guidelines developed for extremely premature infants at NCH proven to be life-changing Oct 31, 2012 | not rated yet | 0
- Discovery may bring special treatment for male babies Mar 25, 2008 | not rated yet | 0
- Maternal obesity may influence brain development of premature infants Mar 08, 2012 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Relating physics forces and entropy
4 hours ago Consider proton and electron are seperated in space at some finite distance.Now suppose they released then the decrease in potential energy equals...
Force Between Two Concentric Solenoids
8 hours ago Imagine a finite length solenoid with outer radius R1 and inner radius R2. This solenoid has a time-varying current going though it. This solenoid is...
Synchrotron, question about insertion devices and electron velocity
8 hours ago When an electron enters an insertion device (wiggler and undulator) from the storage ring in a synchrotron the tangential velocity is equal to the...
Equating differentials => equating coefficients
10 hours ago Hi all, In thermodynamics one often has equations like A dx + B dy = ∂f/∂x dx + ∂f/∂y dy From which follows A = ∂f/∂x B = ∂f/∂y
The idea behind a reverse shock
15 hours ago So in a supernova explosion for example (5th slide) http://www.astro.princeton.edu/~burrows/classes/541/blastwavesChisari.pdf Ambient medium is...
Guass's Law for a charge distribution
16 hours ago First, this is not a homework question, just something I've been confused about for some time. I understand how to use Guass's law in many ways but...
- More from Physics Forums - Classical Physics
More news stories
Existing research shows that bicyclists who wear helmets have an 88 percent lower risk of brain injury, but researchers at Boston Children's Hospital found that simply having bicycle helmet laws in place showed a 20 percent ...
Pediatrics May 23, 2013 | not rated yet | 0
(HealthDay)—Over the last decade, the number of American children who die each year awaiting an organ donation dropped by more than half, new research reveals. And increasing numbers of children are receiving ...
Pediatrics May 22, 2013 | not rated yet | 0
Phthalates: Study links chemicals widely found in plastics, processed food to elevated blood pressure in children, teens
Plastic additives known as phthalates (pronounced THAL-ates) are odorless, colorless and just about everywhere: They turn up in flooring, plastic cups, beach balls, plastic wrap, intravenous tubing and—according to the ...
Pediatrics May 22, 2013 | not rated yet | 1 |
A study by Alexandra L. C. Martiniuk, M.Sc, Ph.D., of The George Institute for Global Health, Sydney, Australia, and colleagues suggests less sleep per night is associated with a significant increase in the risk for motor ...
Pediatrics May 20, 2013 | not rated yet | 0
Whole-cell pertussis vaccines were more effective at protecting against pertussis than acellular pertussis vaccines during a large recent outbreak, according to a new Kaiser Permanente study published in Pediatrics.
Pediatrics May 20, 2013 | not rated yet | 0 |
Coenzyme Q10 decreases all cause mortality by half, according to the results of a multicentre randomised double blind trial presented today at Heart Failure 2013 congress. It is the first drug to improve heart failure mortality ...
21 hours ago | 5 / 5 (6) | 5
Heart failure accelerates the aging process and brings on early andropausal syndrome (AS), according to research presented today at the Heart Failure Congress 2013. AS, also referred to as male 'menopause', was four times ...
21 hours ago | 5 / 5 (1) | 1
(HealthDay)—Animals make great companions for senior citizens, but elderly people who always drive with a pet in the car are far more likely to crash than those who never drive with a pet, researchers have ...
13 hours ago | not rated yet | 1
(Medical Xpress)—A research team, led by Jeremy Barr, a biology post-doctoral fellow, unveils a new immune system that protects humans and animals from infection.
May 20, 2013 | 4.8 / 5 (31) | 9 |
Until now, little was scientifically known about the human potential to cultivate compassion—the emotional state of caring for people who are suffering in a way that motivates altruistic behavior.
May 22, 2013 | 4.3 / 5 (6) | 6 |
Salamanders' immune systems are key to their remarkable ability to regrow limbs, and could also underpin their ability to regenerate spinal cords, brain tissue and even parts of their hearts, scientists have ...
May 20, 2013 | 4.9 / 5 (7) | 5 |