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The early development of head control in preterm infants
Insights
This study tracks head control development in preterm infants. Normal development correlates with muscle growth, while motor handicaps show persistent early movement patterns.
Area of Science:
- Neonatal development
- Pediatric neurology
- Motor control research
Background:
- Head control is a critical developmental milestone in infants.
- Understanding the nuances of head control development in preterm infants is essential for early identification of potential motor delays.
Purpose of the Study:
- To longitudinally document head control development in preterm infants.
- To investigate the relationship between head control progression and muscle development.
- To identify early indicators of motor handicap in preterm infants.
Main Methods:
- Longitudinal study of 104 infants born between 25-33 weeks gestation.
- Standardized assessments of head control and motor development.
- Correlation analysis of developmental rates with muscle development and extra-uterine experience.
Main Results:
- Protective side head turning evolves with reduced spinal extension.
- Normal motor outcome correlated with caudo-cephalic muscle development (P < 0.001, r = 0.5).
- Infants with motor handicap exhibited persistent early movement patterns; preterm infants born <31 weeks showed advanced head control at 33-35 weeks post-menstrual age.
Conclusions:
- The spinal extension movement during side head turning is specific to preterm infants.
- Individual rates of preterm head control development can be assessed through standardized examinations.
- While group delays were observed in infants with later motor handicaps, these were not individually significant during the preterm period.
Abstract:
This study documents the longitudinal development of head control in 104 infants born at 25-33 weeks gestation. Protective side turning of the head was found to have a developmental sequence of reducing spinal extension. In the 93 infants with normal motor outcome, individual differences in the rate of development correlated with caudo-cephalic muscle development (P less than 0.001, r = 0.5) but not with the length of extra-uterine experience. As a group, the 11 infants with later motor handicap showed a persistence of the early form of movement at 35-39 weeks post-menstrual age, without a significant correlation with the ratio of upper-lower limb muscle development. Head control, supine to sitting, in the infants with normal motor outcome showed variations in the rate of preterm development. The infants born at less than 31 weeks showed significantly higher scores at 33-35 weeks post-menstrual age than those born at 31-33 weeks (P less than 0.01). There was no difference at later ages. The spinal extension movement accompanying protective side turning of the head is age specific to the preterm infant. Individual rates of normal preterm development can be evaluated by longitudinal standardised examination. As a group, the infants with subsequent abnormal motor development showed delay at preterm age but this was not individually significant.