Vagal activity, gastric motility, and weight gain in massaged preterm neonates

OBJECTIVE: Multiple studies have documented an increase in weight gain after 5 to 10 days of massage therapy for preterm neonates. The massaged preterm neonates did not consume more calories than the control neonates. One potential mechanism for these effects might involve massage-induced increases in vagal activity, which in turn may lead to increased gastric motility and thereby weight gain. STUDY DESIGN: The present randomized study explored this potential underlying mechanism by assessing gastric motility and sympathetic and parasympathetic nervous system activity in response to massage therapy (moderate pressure) versus sham massage (light pressure) and control conditions in a group of preterm neonates. RESULTS: Compared with preterm neonates receiving sham massage, preterm neonates receiving massage therapy exhibited greater weight gain and increased vagal tone and gastric motility during and immediately after treatment. Gastric motility and vagal tone during massage therapy were significantly related to weight gain. CONCLUSION: The weight gain experienced by preterm neonates receiving moderate-pressure massage therapy may be mediated by increased vagal activity and gastric motility.     

新生儿重症监护室环境布局对极/超早产儿临床结局及神经发育的影响

目的 探讨新生儿重症监护室（neonatal intensive care unit,NICU）环境布局对极/超早产儿临床结局及神经发育的影响。方法 选取重庆医科大学附属儿童医院2021年1月—2022年6月收治、生后24 h内入院的304例极/超早产儿为研究对象。采用回顾性队列研究方法,根据NICU不同环境布局将患儿分为两组,即集中式布局组（157例）和分散式布局组（147例）,比较两组患儿临床结局和校正胎龄34～51+6周时婴儿运动表现测试评分结果。结果 分散式布局组支气管肺发育不良（44.9%vs 62.4%）和颅内出血（17.7%vs 28.0%）的发生率低于集中式布局组（均P<0.05）;分散式布局组治愈率高于集中式布局组（68.7%vs 56.7%,P<0.05）。在校正胎龄34～51+6周时,分散式布局组婴儿运动表现测试评分高于集中式布局组（P<0.05）。结论 NICU分散式环境布局较集中式布局在极/超早产儿临床结局及早期神经发育方面显示出积极的影响。[中国当代儿科杂志,2023,25(8):812-817]     

Factors associated with successful establishment of breastfeeding in very preterm infants

Aim: To describe feeding practices at hospital discharge in relation to characteristics of the very preterm infants (VPI) and their mothers. Methods: Design. Prospective hospital‐based registration of very preterm infants born with a gestational age ≤32 weeks in Denmark during 2004–2008. Subjects. Healthy mothers and VPI without diseases causing eating disabilities at discharge. Results: A total of 478 VPI were registered. At discharge, 60% were exclusively breastfed, 35% were exclusively bottlefed, and 5% were both breast‐ and bottle‐fed. Mothers of high social class (p = 0.000) and ‘not smoking’ (p = 0.003) were significantly more often breastfeeding their preterm infant(s) at discharge. Single births infants tended more often to be breastfed (p = 0.09). Infant age at discharge and duration of hospitalization did not influence breastfeeding at discharge. Increase in weight z‐score from birth to discharge was largest in the bottlefeeding‐group compared with the breastfeeding‐group (p = 0.000) probably as a result of feeding practice the last week(s) of hospitalization. Conclusion: Breastfeeding can successfully be established in very preterm infants. Mothers of low social classes, smokers, multiple birth and very preterm infants with low weight for age may need extra attention in breastfeeding establishing policies.     

Acute renal failure SNAPPE and mortality

Background: The aim of the present study was to determine, using the score for neonatal acute physiology and perinatal extension II (SNAPPE‐II), whether there is an association with acute renal failure (ARF) and whether it is possible to identify newborns at risk for ARF prior to a rise in creatinine in newborns. Methods: Information on postnatal risk factors and SNAPPE‐II on the first day of life (non‐ARF group, n= 475; ARF group, n= 78) were collected. Renal failure was defined as serum creatinine level >1 mg/dL and >1.3 mg/dL (for ≥33 weeks and <33 weeks, respectively) after 48 h of life. Results: In newborns with ARF (n= 78), the median (range) of SNAPPE‐II and mortality rate were significantly higher than those of the control group. Patent ductus arteriosus (PDA), disseminated intravascular coagulation (DIC), SNAPPE‐II, and resuscitation were identified as independent predictors of ARF in infants on forward stepwise logistic regression. Sepsis, respiratory distress syndrome, ARF, DIC, and SNAPPE‐II were identified as independent predictors of mortality in infants on the same analysis. Conclusions: SNAPPE‐II on the first day of life was significantly higher among babies with ARF, suggesting a positive association between higher scores and the development of ARF and mortality, but based on receiver operating characteristic curve results, SNAPPE‐II at admission did not enhance the assessment of risk for ARF prior to a rise in creatinine.     

Maternal antenatal profile and immediate neonatal outcome in VLBW and ELBW babies

Objective To evaluate the antenatal profile of the mother and the immediate neonatal morbidity and mortality till discharge. Methods The study was a retrospective analysis of 92 patients of preterm labour who delivered babies weighing <1500 gms at 26 weeks to 34 weeks of gestation. The maternal demographic profile, causes of preterm labour, treatment profile and delivery outcome were recorded. Similarly the immediate neonatal morbidity and mortality were recorded in our case file. Both these data of maternal and neonatal profile were pooled and analysed. Results A total of 92 mothers in preterm labour at 26 to 34 weeks were admitted and subsequently delivered 70 VLBW babies (<1500 gms) and 36 ELBW babies (<1000 gms) including 8 pairs of twins and 3 triplets pregnancies. Majority of the patients (93.4%) were booked. Amongst the various high risk factors for preterm labour, anaemia, during pregnancy (32.6%), bacterial vaginosis (26%), gestational hypertension (18.4%) and pervious history of preterm labour (18.4%) were common associations. Calcium channel blocker (Depin) tocolysis was effective in postponing labour, from 48 hours to more than 2 weeks. The cesarean section rate was very high (67.3%) in our study. The commoner neonatal complications in both VLBW and ELBW babies were RDS, neonatal jaundice and sepsis. Features of IUGR were seen in both the groups (22.8% in VLBW and 22.2% in ELBW babies). The neonatal mortality rate till discharge was 15.7% in VLBW group and 33.3% in ELBW group. The morality rate was highest in 26 to 30 weeks gestation babies and in babies weighing <800 gms. Conclusion Antenatal profile of preterm labour in our series showed a number of high risk factors. The identification of common high risk factors is important for appropriate prenatal care. A better neonatal survival rate was possible due to timely intervention, appropriate management and NICU care facility available in our tertiary care centre.     

Does type of feeding affect body composition in very low birth weight infants? – A prospective cohort study

Background

The aim of the study was to analyse body composition of preterm infants fed with either breast milk or formula compared to a control group of full-term newborns.

Feeding problems in preterm infants of preeclamptic mothers

Aim: Maternal disease can cause prematurity and neonatal complications, notably feeding problems. To determine the relationship between maternal disease and the nature and severity of neonatal feeding problems, we compared feeding profiles, time to demand feeding and length of hospital stay between preterm infants of preeclamptic mothers, mothers with amniotic infection and mothers with other disease causing prematurity. Methods: The retrospective study used labour ward data collected from 2002 to 2005 in a tertiary university centre to analyse three groups of singletons born at <32 completed gestational weeks to mothers with preeclampsia (n = 61), amniotic infection (n = 55) and non‐preeclamptic non‐amniotic infection controls (n = 55). The groups were similar in gestational age, birthweight and sex ratio; all infants received enteral feeding according to departmental guidelines. Feeding profiles and enteral/oral nutrition were compared. Results: Feeding problems occurred in 46% of the preeclamptic group, 11% of the amniotic infection group and 13% of controls. Full oral demand feeding was established at 36 0/7 weeks postmenstrual age, 35 3/7 weeks (P = 0.03) and 35 2/7 weeks (P < 0.0001), respectively. Feeding problems were the main cause of delay (7–10 days) in hospital discharge in the preeclamptic group (P = 0.0002). Conclusions: Feeding problems are greater, and hospital stay longer, in preterm infants of preeclamptic mothers than in other preterm infants.     

The Effects of Non-Nutritive Sucking and Pre-Feeding Oral Stimulation on Time to Achieve Independent Oral Feeding for Preterm Infants

Background:

The survival rates of preterm infants has increased over the last years, but oral feeding difficulties are the most common problems encountered by them

Objectives:

This study aimed at comparing the effects of non-nutritive sucking (NNS) and pre-feeding oral stimulation on feeding skills, length of hospital stay and weight gain of 26-32 weeks gestational age preterm infants in NICU, to determine the more effective intervention.

Patients and Methods:

Thirty-two preterm infants were assigned randomly into three groups. One intervention group received pre-feeding oral stimulation program and the other received non-nutritive sucking stimulation, while the control group received a sham intervention. Gestational age of infants was calculated during 1, 4 and 8 oral feeding and discharge time from NICU. The infants’ weights were measured weekly from birth and at discharge time.

Results:

Mean gestational age on 8 time oral feeding per day, in 3 groups was not significant (P = 0.282). Although NNS and pre-feeding oral stimulation groups has fulfilled this criterion 7.55 and 6.07 days sooner than the control group, respectively (a result which is of great clinical and economic importance), but the difference did not reach statistical significance. Weight gaining at discharge time in NNS group was significantly higher than control and pre-feeding oral stimulation groups (P < 0.05).

Conclusions:

This study revealed that pre-feeding oral stimulation and NNS programs both were effective on oral feeding skills and weight gaining of the immature newborns. Yet, it seems that NNS program was more effective than pre-feeding oral stimulation on weight gaining.     

Association of late-onset neonatal sepsis with late neurodevelopment in the first two years of life of preterm infants with very low birth weight

Objectiveto establish the influence of late-onset sepsis on neurodevelopment of preterm infants with very low birth weight (VLBW), according to the etiologic agent.Methodthis was a cohort of newborns with birth weight < 1,500 g and gestational age less than 32 weeks, admitted to the institutional intensive care unit (ICU) with up to 48 hours of life, and followed-up at the outpatient follow-up clinic for preterm infants with VLBW until 2 years of corrected age. Exclusion criteria: death within the first 72 hours of life, congenital malformations and genetic syndromes, children with congenital infection by the human immunodeficiency virus (HIV), congenital infection (STORCH), presence of early-onset sepsis and cases with more than one pathogen growth in blood cultures. Septic and non-septic infants were compared regarding neonatal outcomes and mortality. Neurodevelopment was assessed using the Bayley Scale (BSDI-II) at 18 to 24 months of corrected age.Results411 preterm infants with VLBW were eligible; the mean gestational age was 29 ± 2.2 weeks and mean birth weight was 1,041 ± 281grams. Late-onset sepsis occurred in 94 preterm infants with VLBW (22.8%). VLBW infants with Gram-positive infection showed motor deficit when compared to the non-septic group, 68.8% vs. 29.3%, respectively (OR 6; 1.6-21.8, p = 0.006); the cognitive development was similar between the groups. The overall mortality rate from infection was 26.7%; considering the pathogens, the rates were 18.7% for coagulase-negative Staphylococcus, 21.8% for Gram-positive bacteria, and 50% for Gram-negative bacteria and fungi.Conclusionneonatal sepsis has a significant influence on late neurodevelopment at 2 years of corrected age in preterm infants with VLBW, and Gram-positive infections are associated with motor deficit.     

Clinical effects of oral motor intervention combined with non-nutritive sucking on oral feeding in preterm infants with dysphagia

ObjectiveTo explore the effectiveness of oral motor intervention combined with non-nutritive sucking in treating premature infants with dysphagia.MethodsSixty preterm infants admitted to the neonatal intensive care unit of the present study's hospital were selected and randomly divided into the control and intervention groups. The control group was given non-nutritive sucking intervention alone, while the intervention group was given oral motor intervention combined with non-nutritive sucking. The oral motor ability, milk sucking amount and sucking rate, feeding efficiency and outcomes, and the occurrence of adverse reactions were measured and compared.ResultsCompared to first-day interventions, preterm infant oral feeding readiness assessment scale-Chinese version (PIOFRAS-CV) scores of the two groups significantly increased after 14 days of intervention, and this score was higher in the intervention group compared to the control group. Similarly, after 14 days of intervention, the intervention group's milk sucking rate and amount were significantly higher than the control group. Also, after the intervention, the intervention group's total oral feeding weeks were considerably lower, while the feeding efficiency and body weight were significantly higher than the control group. Moreover, the overall adverse reaction rate in the intervention group was lower than that in the control group.ConclusionsOral motor intervention combined with non-nutritive sucking can significantly improve the oral motor ability of premature newborns, promote the process of oral feeding, improve the outcome of oral feeding, and reduce the occurrence of adverse effects. The combined intervention seems to have a beneficial effect on oral feeding proficiency in preterm infants.     

Outcomes of very‐low‐birthweight infants after discharge with a discharge weight of 1500 grams

Background: Discharge of very‐low‐birthweight (VLBW) neonates from hospital is an important issue and has a standard criterion worldwide. According to this criterion, VLBW infants will be discharged from hospital when weighing 1800–2100 g but in the newborn services at Amirkola Children's Hospital (ACH), VLBW neonates are discharged when reaching 1500 g. The aim of this study was to determine the safety of this policy. Methods: In this analytic‐prospective study, 100 premature neonates with discharging weight (DW) of 1500 g and a control group of 150 neonates with DW of 1600–2500 g were included. Both groups showed similar socioeconomic, perinatal and postnatal conditions. They were admitted and treated in the newborn services at ACH. The outcome variables, including death after discharge, readmission and need for emergency visit for an acute problem up to 3 months after discharge, were studied. The information was analyzed by spss ‐16 software and a P‐value < 0.05 was considered significant. Results: Need for emergency visit after discharge reached a significant difference between the two groups (31 in the case group vs 21 in the control group, P= 0.000), but there were no significant differences in the readmission rate and death after discharge (two deaths and 15 readmissions in the case group vs two deaths and 21 readmissions in the control group, P= 0.855) Conclusion: In order to decrease the need for emergency visits, we suggest a program of early hospital discharge with home nursing visits and neonatologist support.     

Oil massage in neonates: an open randomized controlled study of coconut versus mineral oil

INTRODUCTION: Oil massage for newborns is reported to improve weight gain by better thermoregulation. A role for transcutaneous absorption has also been suggested. AIMS AND OBJECTIVES: This study was undertaken to compare the effect of massage with coconut oil versus mineral oil and placebo (powder) on growth velocity and neuro-behavior in well term and preterm babies. STUDY DESIGN: Open Randomized Controlled trial. SETTING: The Premature unit and the postnatal wards of a major teaching hospital in a metropolitan city. MATERIAL AND METHODS: Intramural preterm appropriate for gestational age babies weighing between 1500 to 2000 grams and term births weighing more than 2500 grams fulfilling the inclusion criteria constituted the two gestation age categories studied. Babies in each group were randomized to receive massage with either coconut oil, mineral oil or with placebo. Oil massage was given by a trained person from day 2 of life till discharge, and thereafter by the mother until 31 days of age, four times a day. Babies were followed up daily till discharge and every week after discharge for anthropometry. Neuro-behavioral outcome was assessed by the Brazelton Score at baseline, day 7 and on day 31. RESULTS: Coconut oil massage resulted in significantly greater weight gain velocity as compared to mineral oil and placebo in the preterm babies group; and in the term baby group, as compared to the placebo. Preterm infants receiving coconut oil massage also showed a greater length gain velocity compared to placebo group. No statistically significant difference was observed in the neurobehavioral assessment between all three subgroups in term babies as well as in preterm babies.     

Hydrocortisone and long‐term outcomes in very‐low‐birthweight infants

Background: The long‐term effects of hydrocortisone (HDC) used for very‐low‐birthweight (VLBW) infants with chronic lung disease (CLD) are not fully understood. The aim of this study was to examine the short‐term clinical effects and long‐term impact of a physiological replacement dose of HDC on acute deterioration of CLD in VLBW infants. Methods: This prospective case–control study included 110 of the 174 VLBW infants admitted to our facility between 2003 and 2006 who were followed up to a corrected age of 18 months. Infant deaths and infants with congenital deformities were excluded from the study. The infants were classified into the following three groups: infants with CLD and treated with HDC (1–2 mg/kg/dose) due to progressive deterioration in oxygenation (CLD treatment group; n= 24); infants with CLD but not treated with HDC (CLD untreated group; n= 40); and infants without CLD (non‐CLD group; n= 46). Results: The fraction of inspired oxygen (F_IO₂) in the CLD treatment group improved significantly after treatment (P < 0.01). There were no significant differences among the three groups in terms of growth and neurodevelopmental quotient at the corrected age of 18 months following adjustment for birthweight, sex, and presence of light‐for‐date infants. There were also no significant intergroup differences in all three areas of developmental quotient. Conclusions: Physiological doses of HDC replacement are effective in treating acute deterioration in oxygenation in VLBW infants with CLD. Furthermore, this treatment modality did not adversely affect the growth and development of infants at the corrected age of 18 months.     

Clinical characteristic comparison of low birth weight and very low birth weight preterm infants with neonatal necrotizing enterocolitis: a single tertiary center experience from eastern China

Purpose

This study aims to understand the clinical characteristics of preterm neonatal necrotizing enterocolitis (NEC) to improve the medical management level.

Methods

The clinical characteristics of preterm NEC infants with low birth weight (LBW, ≥?1500 g) and very low birth weight (VLBW, <?1500 g) were compared. Then, clinical information, including demographics, surgical interventions and morbidity, were collected.

Results

A total of 149 preterm NEC infants (60 with VLBW and 89 with LBW) were enrolled. Their median birth weight and gestational age were 1600 g and 31 weeks, respectively. Respiratory support and surfactant therapy were more frequent in VLBW infants (90% vs. 38% and 75% vs. 21.3%) than in LBW infants. In addition, 70.5% of these infants were fed by formula before the NEC occurred. Prematurity-associated morbidities were significantly higher in VLBW infants. Furthermore, 12.8% of all NEC infants died at discharge, and mortality was more prevalent in VLBW infants (21.7% vs. 6.7%). The most frequently received surgeries were enterostomy (n?=?58), primary anastomosis (n?=?42), and peritoneal drainage (n?=?2). Multifocal, localized and pan-intestinal disease occurred in 77.5%, 19.6% and three infants, respectively. Furthermore, postoperative complications occurred more frequently in VLBW infants.

Conclusion

The overall mortality was 12.8% for infants who had a larger mean gestational age and birth weight, when compared to that in developed countries. Higher rate of formula feeding might be an important risk factor for NEC development. Furthermore, mortality and morbidities, especially nutrition-associated complications, were more frequent in VLBW infants.

     

Preterm infant weight gain is increased by massage therapy and exercise via different underlying mechanisms

Objective

To compare the effects of massage therapy (moderate pressure stroking) and exercise (flexion and extension of limbs) on preterm infants' weight gain and to explore potential underlying mechanisms for those effects.

Methods

Weight gain and parasympathetic nervous system activity were assessed in 30 preterm infants randomly assigned to a massage therapy group or to an exercise group. Infants received 10 min of moderate pressure massage or passive flexion and extension of the limbs 3 times per day for 5 days, and EKGs were collected during the first session to assess vagal activity.

Results

Both massage and exercise led to increased weight gain. However, while exercise was associated with increased calorie consumption, massage was related to increased vagal activity.

Conclusion

Taken together, these findings suggest that massage and exercise lead to increased preterm infant weight gain via different underlying mechanisms.     

Nasal high flow therapy in very low birth weight infants with mild respiratory distress syndrome: a single center experience

Background

Pulmonary disorders and respiratory failure represent one of the most common morbidities of preterm newborns admitted to neonatal intensive care units (NICUs). The use of nasal high-flow therapy (nHFT) has been more recently introduced into the NICUs as a non-invasive respiratory (NIV) support.

Methods

We performed a retrospective study to evaluate safety and effectiveness of nHFT as primary support for infants born <?29 weeks of gestation and/or VLBW presenting with mild Respiratory Distress Syndrome (RDS).The main outcome was the percentage of patients that did not need mechanical ventilation. Secondary outcomes were rate of bronchopulmonary dysplasia (BDP), air leaks, nasal injury, late onset sepsis (LOS), intraventricular hemorrhage (IVH), retinopathy (ROP), necrotizing enterocolitis (NEC), hemodynamically-significant patent ductus arteriosus (PDA) and death.

Results

Sixty-four preterm newborns were enrolled. Overall, 93% of enrolled patients did not need mechanical ventilation. In a subgroup analysis, 88.5% of infants <?29 weeks and 86.7% of infants ELBW (<?1000 g BW) did not need mechanical ventilation.BPD was diagnosed in 26.6% of preterms enrolled (Mild 20%, Moderate 4.5%, Severe 1.5%). In subgroup analysis, BPD was diagnosed in 53.9% of newborns with GA <?29 weeks, in 53.3% of ELBW newborns and in 11.1% of small for gestational age (SGA) newborns.Neither air leaks nor nasal injury were recorded as well as no exitus occurred. LOS, IVH, ROP, NEC and PDA occurred respectively in 16.1%, 0%, 7.8%, and 1.6% of newborns.

Conclusions

According to our results, n-HFT seems to be effective as first respiratory support in preterm newborns with mild RDS. Further studies in a larger number of preterm newborns are required to confirm nHFT effectiveness in the acute phase of RDS.

     

Spanish population‐study shows that healthy late preterm infants had worse outcomes one year after discharge than term‐born infants

Aim

This study assessed the risks associated with healthy late preterm infants and healthy term‐born infants using national hospital discharge records.

Method

We used the minimum basic data set of the Spanish hospital discharge records database for 2012–2013 to analyse the hospitalisation of newborn infants. The outcomes were in‐hospital mortality and hospital re‐admissions at 30 days and one year after their first discharge.

Results

Of the 95 011 newborn infants who were discharged, 2940 were healthy late preterm infants, born at 34 + 0–36 + 6 weeks, and 18 197 were healthy term‐born infants. The mean and standard deviation (SD) length of hospital stay were 6.0 (4.5) days in late preterm infants versus 2.8 (1.3) days in term‐born infants (p < 0.001). Re‐admissions were also higher in the late preterm group at 30 days (9.0% versus 4.4%) and one year (22.0% versus 12.4) (p < 0.001). The relative risk for death at one year was 4.9 in the late preterm group, when compared to the term‐born infants (p = 0.026).

Conclusion

The hospital discharge codes for otherwise healthy newborn preterm infants were associated with significantly worse 30‐day and one‐year outcomes when their re‐admission and mortality rates were compared with healthy term‐born newborn infants.     

Evaluation of growth and neurodevelopment in children with congenital heart disease

Background: Children with congenital heart disease are under risk of delayed growth and development. We evaluated physical growth parameters and neurodevelopment in these patients in comparison with normal children and examined the effect of hemodynamic status. Methods: Patients with congenital heart disease (n= 76) and healthy children (n= 51) aged 1–72 months applied to Mersin University Hospital, Mersin, Turkey were included. Patients with heart failure and those requiring intervention or surgery were classified as hemodynamically impaired (HI group, n= 30), and the others, hemodynamically normal (HN group, n= 46). Growth parameters including weight, height, body mass index (BMI), mid‐arm circumference (MAC), and triceps skin fold thickness (TSF) were measured and standard deviations (SD) were determined. Functional development was assessed by Denver Developmental Screening Test‐II (DDST II). Results: MAC and BMI values of the group with impaired hemodynamic status were significantly lower than the hemodynamically normal and control groups (MAC P < 0.05 and BMI P < 0.01). In the DDST II, the group with hemodynamic abnormality had more failures in gross motor and fine motor skills than HN group and controls (gross motor P= 0.011, P < 0.001 and fine motor P= 0.028, P= 0.001, respectively) and more failures in language development than the control group (P= 0.001). Conclusion: The results showed the importance of hemodynamic status in growth and neurodevelopment of children with congenital heart disease. Besides routine growth parameters, more detailed examinations such as BMI, MAC, TSF, and developmental screening tests appear useful in identifying children with cardiac disease who are under risk for delayed growth and development.     

Is it possible to predict the infant's neurodevelopmental outcome at 14 months of age by means of a single preterm assessment of General Movements?

Background

It continues to be a challenge for clinicians to identify preterm infants likely to experience subsequent neurodevelopmental deficits. The Test of Infant Motor Performance (TIMP) and the assessment of spontaneous general movements (GMs) are the only reliable diagnostic and predictive tools for the functionality of the developing nervous system, if applied before term.

Aim

To determine to what extent singular preterm assessments of motor performance can predict the neurodevelopmental outcome in 14-month olds.

Methods

Thirty-seven preterm infants born < 34 weeks gestational age were recruited for the study at the NICU of the São Lucas University Hospital, Porto Alegre, RS, Brazil. At 34 weeks, their GMs were assessed; and the Test of Infant Motor Performance (TIMP) was applied. A prospective design was used to examine (A) the association between the GM assessment and the TIMP; and (B) the relation between GMs or the TIMP and the developmental status at 14 months, assessed by means of Alberta Infant Motor Scales (AIMS) and the Pediatric Evaluation of Disability Inventory (PEDI).

Results

Nineteen infants (41%) had abnormal GMs; only one scored within the TIMP average range. Hence, GMs and TIMP were not related. Children with cramped-synchronized GMs at 34 weeks preterm had a lower AIMS centile rank than those with poor repertoire or normal GMs. There was a marginal association between cramped-synchronized GMs and a lower PEDI mobility score.

Conclusions

A single preterm GM assessment is only fairly to moderately associated with the 14-month motor development. The TIMP is not suitable as a complementary assessment tool at such a young age.