Ventilatory support exposure in the neonatal intensive care unit and head and body positioning at term-equivalent age in preterm infants: A retrospective cohort study.

BACKGROUND

Neonatal intensive care (NICU) is essential for the survival of preterm infants; however, exposure to interventions such as ventilatory support within the NICU may influence early motor organization and developmental trajectories.

OBJECTIVE

To investigate whether ventilatory support during neonatal hospitalization is associated with head and body positioning in preterm infants at term-equivalent age.

METHODS

This retrospective cohort study included 92 preterm infants. Spontaneous movements were recorded for up to 5 min between 37 and 40 weeks of corrected age and independently analyzed by two blinded researchers. Head and body positioning were evaluated using a study-specific instrument based on three items derived from the Motor Optimality Score. Each item was classified as typical or atypical. In addition, a gestalt assessment of preferred head position was performed. Binomial regression models were fitted to examine the association between ventilatory support and head and body positioning. Variables with p < 0.10 in bivariate analyses were included in the model.

RESULTS

Only 15% (13) of preterm infants exhibited a central head position, while 62% (57) displayed a right-sided head preference. Infants who required ventilatory support had threefold higher odds of absent head movement and 89% lower odds of maintaining symmetrical body alignment compared with unexposed peers.

CONCLUSION

Exposure to ventilatory support is associated with postural asymmetries and reduced head mobility at term-equivalent age. These findings highlight the importance of appropriate positioning practices and warrant attention from professionals involved in neonatal intensive care.