Early human development · 2026
Early neurobehavior and general movements in high-risk preterm infants: Interrelationships and associations with medical and social factors.
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Liszka Lara, Nguyen Tiana, Ibraham Carolyn, Pineda Roberta
Аннотация
OBJECTIVE: To investigate 1) relationships between medical and sociodemographic factors and neurobehavior and general movement scores during the writhing period, and 2) relationships between the General Movement Assessment (GMA), Hammersmith Neonatal Neurological Evaluation (HNNE), and NICU Network Neurobehavioral Scale (NNNS) at term-equivalent age.
STUDY DESIGN: Seventy-eight preterm infants (born ≤32 weeks gestation) from a level IV NICU were prospectively enrolled and had neurobehavioral assessments of HNNE and NNNS conducted at term-equivalent age. Fifty-six of these infants also had GMA testing. Relationships between medical factors and sociodemographic factors were explored via independent samples t-test, chi-square analyses, ANOVA, and linear regression models. Relationships between GMA scores and neurobehavioral summary scores on the HNNE and NNNS were explored via ANCOVA, controlling for PMA at testing. Relationships between HNNE and NNNS scores were investigated using multivariate regression analysis.
RESULTS: Lower HNNE scores were associated with intraventricular hemorrhage, single parent household, and single-parent living situation. Poorer NNNS scores were associated with Cesarean delivery, public insurance, higher postmenstrual age at discharge, advanced maternal age, African American/Black race, retinopathy of prematurity, chronic lung disease, and intraventricular hemorrhage. Cramped-synchronized general movements were associated with retinopathy of prematurity and lower household income. Cramped-synchronized general movements were associated with retinopathy of prematurity and lower household income. Cramped-synchronized general movements were associated with lower HNNE total scores and poorer NNNS Arousal and Lethargy. Lower HNNE scores were associated with poorer NNNS Self-regulation, Suboptimal Reflexes, Hypotonia, Orientation, and Lethargy. All of these reported relationships were statistically significant (p < 0.05).
CONCLUSION: Social and medical factors were related to early neurobehavior, but less so to general movements. Early neurobehavioral performance was related to general movements.
STUDY DESIGN: Seventy-eight preterm infants (born ≤32 weeks gestation) from a level IV NICU were prospectively enrolled and had neurobehavioral assessments of HNNE and NNNS conducted at term-equivalent age. Fifty-six of these infants also had GMA testing. Relationships between medical factors and sociodemographic factors were explored via independent samples t-test, chi-square analyses, ANOVA, and linear regression models. Relationships between GMA scores and neurobehavioral summary scores on the HNNE and NNNS were explored via ANCOVA, controlling for PMA at testing. Relationships between HNNE and NNNS scores were investigated using multivariate regression analysis.
RESULTS: Lower HNNE scores were associated with intraventricular hemorrhage, single parent household, and single-parent living situation. Poorer NNNS scores were associated with Cesarean delivery, public insurance, higher postmenstrual age at discharge, advanced maternal age, African American/Black race, retinopathy of prematurity, chronic lung disease, and intraventricular hemorrhage. Cramped-synchronized general movements were associated with retinopathy of prematurity and lower household income. Cramped-synchronized general movements were associated with retinopathy of prematurity and lower household income. Cramped-synchronized general movements were associated with lower HNNE total scores and poorer NNNS Arousal and Lethargy. Lower HNNE scores were associated with poorer NNNS Self-regulation, Suboptimal Reflexes, Hypotonia, Orientation, and Lethargy. All of these reported relationships were statistically significant (p < 0.05).
CONCLUSION: Social and medical factors were related to early neurobehavior, but less so to general movements. Early neurobehavioral performance was related to general movements.