Correlation of Neonatal Imitation and General Movements Assessment in Late Preterm Infants

Neonatal imitation (NI) is a foundational marker of early social-cognitive development, yet its universality remains debated, particularly in non-WEIRD (Western, Educated, Industrialized, Rich, and Democratic) populations and in infants at higher neurodevelopmental risk. This study examined NI in healthy late-preterm newborns, compared their responses with term infants, and explored the prognostic value of imitation using longitudinal Prechtl's General Movements Assessment (GMA). Twenty-three late-preterm and 27 term infants were tested within 72 h of birth for facial imitation using a blinded, counterbalanced protocol focusing on mouth opening (MO) and tongue protrusion (TP). Neurodevelopmental status was assessed using Prechtl's GMA at corrected ages of 5 and 11 weeks. Both groups exhibited significantly more TP gestures in response to the matching TP model (late-preterm: p = 0.002; term: p < 0.001), whereas MO responses did not differ significantly (p > 0.05). Imitative behavior was present from Day 1 (p = 0.005) and strengthened on Days 2-3 (p < 0.001). No significant sex differences were observed. NI scores did not significantly correlate with GMA outcomes (p > 0.05), likely reflecting the clinical homogeneity of this mostly healthy sample. Selective NI for TP emerges within the first days of life in both late preterm and term infants. By including a non-WEIRD population and late preterm infants, this study expands the generalizability of NI. Strengths include early assessment, blinded scoring, and standardized neurodevelopmental evaluation. NI appears robust across gestational age and sociocultural contexts, highlighting its potential as an early neurobehavioral marker. Further longitudinal research in diverse populations is warranted.