The development of head position preference in preterm infants beyond term age

Area of Science:

• Neonatal development
• Developmental pediatrics
• Neurology

Background:

• Healthy full-term infants typically develop a midline head position by 12 weeks.
• Head position preferences in preterm infants require further investigation.

Purpose of the Study:

• To investigate the effects of intrauterine growth retardation (IUGR) and prematurity on head position development in preterm infants.
• To assess the attainment of right-sided head preference and midline head position in preterm infants.

Main Methods:

• Studied 35 preterm infants (27-34 weeks gestation) from 35 weeks postmenstrual age to 18 weeks corrected age.
• Assessed head turning preferences (initial and sustained) and midline posture.
• Classified infants based on neurological differences, including movement quality.

Main Results:

• Infants born before 32 weeks gestation lacked initial right-sided head turning preference.
• Intrauterine growth retardation (IUGR) did not affect head position preferences.
• A midline head position was not significantly delayed by prematurity or IUGR.
• A delay in midline posture attainment was observed in infants with abnormal movement quality, potentially linked to suboptimal neurological condition or skull flattening.

Conclusions:

• Preterm infants born before 32 weeks gestation may exhibit altered head turning preferences.
• Midline head position development is generally resilient to prematurity and IUGR, but can be impacted by neurological factors.
• Abnormal movement quality in preterm infants may indicate delayed midline posture development, though skull shape can also be a factor.