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Outcome of 100 randomly positioned children of very low birthweight at 2 years
U Aebi1, J Nielsen, D Sidiropoulos
1Cerebral Palsy Centre, Inselspital, Switzerland.
Insights
Premature infants often develop extensor motor patterns. Neonatal positioning did not significantly impact development, but prenatal factors and congenital issues strongly influenced outcomes at 24 months.
Area of Science:
- Neonatal development
- Pediatric neurology
- Developmental pediatrics
Background:
- Prematurely born children, particularly those of very low birthweight, are at high risk for abnormal development.
- A tendency to adopt extensor motor patterns is common in these infants during early childhood.
Purpose of the Study:
- To investigate the impact of neonatal positioning on the developmental outcomes of premature infants.
- To identify factors influencing the long-term development of high-risk infants.
Main Methods:
- A randomized controlled trial assessing the effect of ordinary versus flexed positioning during the neonatal period.
- Analysis of the optimality score in 100 consecutively born infants at the University Women's Hospital, Bern.
- Assessment of developmental outcomes at 24 months corrected age.
Main Results:
- Neonatal positioning (ordinary or flexed) did not show a statistically significant influence on infant development at 24 months corrected age.
- Prenatal optimality score was significantly associated with later developmental outcomes.
- Congenital malformations were also found to significantly impact the developmental trajectory of these children.
Conclusions:
- Routine neonatal positioning strategies do not appear to significantly alter developmental outcomes for premature infants.
- Prenatal factors and the presence of congenital malformations are critical determinants of long-term development in high-risk infants.
Abstract:
Prematurely born children often show a tendency to adopt extensor motor patterns during the first years of life. These children and especially those children of very low birthweight are considered to be at high risk for abnormal development. Positioning in an ordinary manner or in a more flexed position imposed at random during the neonatal period until discharge from hospital did not have a statistically significant influence on the development of these children at 24 months after term. Analysis of the optimality score of the 100 randomly selected children, born consecutively at the University Women's Hospital, Bern, showed a significant influence of prenatal optimality and congenital malformations on their later outcome.