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Outcome of very low birth weight (VLBW) infants. I. Neonatal behavior of 188 infants
Insights
Very low birth weight infants exhibit distinct behavioral patterns, including lower reflex scores and reduced visual responsiveness compared to term infants. Behavioral capacity, not just age, is key for assessing these infants using the Brazelton Neonatal Behavioral Assessment Scale.
Area of Science:
- Neonatal behavioral assessment
- Infant development studies
Background:
- Very low birth weight (VLBW) infants (<1,501 gm) present unique developmental trajectories.
- Standardized behavioral assessments are crucial for understanding VLBW infant development.
Purpose of the Study:
- To characterize the behavioral patterns of VLBW infants.
- To evaluate the utility of the Brazelton Neonatal Behavioral Assessment Scale (BNBAS) and preliminary items for premature infants.
- To identify perinatal predictors of VLBW infant behavior.
Main Methods:
- Assessed 188 VLBW infants using the BNBAS and preliminary premature infant scale items.
- Optimized assessment timing for social interaction.
- Analyzed perinatal factors (birth weight, gestational age) as predictors.
Main Results:
- VLBW infants were less easily upset and showed lower reflex scores and visual responsiveness than term infants.
- Preliminary scale items improved assessment of interactive abilities and tolerance.
- Orienting responses were suboptimal in infants tested late (post-44 weeks) due to illness.
- Perinatal factors predicted some motor and state control responses.
Conclusions:
- Behavioral capacity, rather than chronological age, should guide the application of the BNBAS for VLBW infants.
- The BNBAS and adapted items provide valuable insights into VLBW infant behavior.
- Perinatal factors influence early motor and state control, warranting further longitudinal study.
Abstract:
Behavioral characteristics of very low birth weight infants (less than 1,501 gm) were determined with the term Brazelton Neonatal Behavioral Assessment Scale and selected items from a preliminary form of the scale for premature and at-risk infants. The behavior of 188 infants was assessed at a time as optimal as possible for social interaction. Our very low birth weight infants were upset less easily, had several reflexes with below average scores, and were less responsive to visual stimuli than term infants of other studies. Improved description of interactive abilities and tolerance of the testing procedure was made possible with some items from the preliminary premature scale. Orienting responses in 6 infants tested after 44 weeks because of prolonged illness were less than optimal with a single exception. This suggests that behavioral capacity, not age, should define where the Brazelton scale is not applicable. Perinatal factors including birth weight, gestational age, and age that weight gain began, predicted some motoric and state control responses. Whether this predictive capacity will persist or change with time awaits results of follow-up of these infants.