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Behavioral and electrophysiological evidence for gestational age effects in healthy preterm and fullterm infants
F H Duffy1, H Als, G B McAnulty
1Children's Hospital, Boston, MA 02115.
Insights
Premature birth impacts infant behavior and brain activity, with full-term infants showing superior outcomes. These differences are partly due to complications and altered sensory experiences in premature infants.
Area of Science:
- Neonatal development
- Developmental neuroscience
- Pediatric neurology
Background:
- Gestational age at birth is a critical factor influencing infant neurodevelopment.
- Understanding the specific impacts of prematurity on infant behavior and brain function is essential for early intervention.
Purpose of the Study:
- To investigate the effects of gestational age at birth on behavioral and electrophysiological measures in healthy infants.
- To compare outcomes between early preterms, middle-group preterms, and full-term infants.
Main Methods:
- Studied 135 infants stratified by gestational age: early preterms (26-32 weeks), middle preterms (33-37 weeks), and full-terms (38-41 weeks).
- Assessed behavior using the Assessment of Preterm Infants' Behavior (APIB).
- Measured brain electrical activity using brain electrical activity mapping (BEAM) and analyzed EEG spectral and photic evoked responses.
Main Results:
- Full-term infants demonstrated significantly better behavioral function compared to both preterm groups.
- Preterm infants exhibited significantly lower amplitude EEG spectral and photic evoked responses than full-term infants.
- Path analysis indicated that postnatal complications explained some gestational age effects on behavioral and electrophysiological variables.
Conclusions:
- Differences in behavioral and electrophysiological measures are partly attributable to unavoidable complications associated with premature birth.
- Remaining differences may stem from altered sensorimotor stimulation due to the premature extrauterine environment.
- Gestational age significantly impacts infant neurodevelopmental trajectories.
Abstract:
We investigated the effects of gestational age at birth on behavioral and electrophysiological measures of 135 medically healthy infants, studied at 42 weeks postconception, and stratified into 3 groups--early-born preterms, 26-32 weeks (n = 55); middle-group preterms, 33-37 weeks (n = 43); and fullterms, 38-41 weeks (n = 37). Subjects were studied behaviorally with the Assessment of Preterm Infants' Behavior (APIB) and electrophysiologically with brain electrical activity mapping (BEAM). Fullterms showed significantly better behavioral function than both preterm groups. Less difference was found between the preterm groups. EEG spectral and photic evoked response were of significantly less amplitude for the preterms than the fullterms. Path analysis showed gestational age effects on behavioral (3 of 6) and electrophysiological (13 of 17) variables due to postnatal complications. We conclude that some differences attributable to gestational age at birth are explained by the cumulative effect of minor but unavoidable complications associated with premature birth. We speculate that remaining effects may result from developmentally inappropriate sensorimotor stimulation consequent to the premature experience of an extrauterine environment.