Aim To determine the relationship of head turn preference in the preterm infant to: 1) perinatal medical factors, 2) neonatal neurobehavior, and/or 3) infant neurodevelopmental outcomes. Methods Seventy preterm infants born ≤30 weeks gestation were enrolled at birth. Detailed information regarding neonatal intensive care unit (NICU) medical course was compiled for each infant. Neurobehavioral testing was performed during NICU hospitalization. Head turn preference was quantified at term equivalent age using a newly developed scale. Infants returned at age two years for standardized developmental testing. Results All infants demonstrated a head turning preference, with most preferring the right side (n = 51, 77%). Fifty-five infants (79%) had moderate to severe head turn preference. Head turn preference was associated with 1) medical severity (hours of inotrope use, p = 0.02; oxygen requirement at 36 weeks postmenstrual age, p = 0.03), 2) worse neurobehavioral performance (decreased self-regulation, p = 0.007; more sub-optimal reflexes p = 0.006), and 3) worse developmental outcome at age two years (poorer fine motor, p = 0.02). Interpretation Medical factors in the NICU appear to be associated with the development of a head turn preference. Increased severity of head turn preference may be a marker for poor developmental outcome. Early identification may inform therapeutic interventions designed to minimize symptoms and optimize neurodevelopmental outcome.
Date Presented 4/17/2015 Head turn preference in the preterm infant is not associated with medical factors in the neonatal intensive care unit (NICU); however, it is associated with early neurobehavior and asymmetric movement patterns, and it is also a marker for adverse developmental outcome at age 2 yr.
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