State behavior of preterm infants as a function of development, individual and sex differences

Korner, Anneliese F.; Brown, Byron W.; Reade, Elaine P.; Stevenson, David K.; Fernbach, Stephen A.; Thom, Valerie A.

doi:10.1016/s0163-6383(88)80020-1

Cited by 29 publications

(19 citation statements)

References 17 publications

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“…The newborn sex differences in state organization observed in the present study is coordinate with the results of Korner et al (1988). They reported that female premature infants were more likely than males to remain in alert states during the ministrations associated with a neurobehavioral assessment technique.…”

supporting

confidence: 87%

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Sex differences in neonatal state and lateralized head orientation

Michel

Harkins

Meserve

1990

Infant Behavior and Development

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Abstract:Sex differences in state and head orientation were examined 10 to 22 hours after birth for 50 healthy, full-term, normal, vaginally delivered neonates. None of the males had been circumcised at the time of testing. The procedure required videotaping for 30 min in three different conditions: supine, seated in an infant seat (inclined 35°), and seated in an assistant,s lap after having arms or legs manipulated for 10 s. Videotapes were analyzed for direction of infant,s head orientation and state. Males spent more time in sleep states than females, and females spent more time than males in alert states. The left or right direction of head orientotion was more associated with alert states for females and with sleep states for males. This sex difference may be relevant for sex differences in handedness and other forms of hemispheric specialization of function. Article:State is the dominant characteristic of the newborn behavioral repertoire, influencing the infant's display of specific behaviors and reflexes, orientation and responsivity to environmental stimulation, and posture (Casaer, 1979;Korner, 1969Korner, , 1972Prechtl, 1974;Wolff, 1966Wolff, , 1987. Of particular interest have been reports of the relation between the infant's state and pattern of supine head orientation (Cornwell, Fitzgerald, & Harris, 1985;Michel & Goodwin, 1979). The heads of supine infants are more likely to be oriented laterally during quiet-alert and active-alert states than during a fussy or crying state (Cornwell et al., 1985;Michel & Goodwin, 1979). The present study examines the relations of newborn state and sex to supine lateral head orientation.The designs of the Cornwell et al. (1985) and the Michel and Goodwin (1979) studies limited the generality of their conclusions about the influence of state on newborn supine head orientation. Both studies assessed state during a very short time period (4 and 3 min, respectively). Cornwell et al. provided no data before the 2-week assessment. Therefore, the data from Cornwell et al. are not very revealing about the influence of state on newborn supine head orientation. The Michel and Goodwin study did focus on the newborn; however, not only was the assessment period extremely short, but the influence of state on head orientation was only a minor aspect of that study. In order to assess the influence of state on newborn behavior, either the length of the observation period must be long enough to insure alert states or procedures must be employed to provoke the alert states.Control for potential differences between the sexes also must be made when assessing newborn state. Korner et al. (1988) reported that preterm males were more frequently in states of sleep or waking activity (fussiness) at 34 weeks postconceptual age, whereas same-aged preterm females slept less than males and were more often in a quiet-awake state. These sex differences were also found to be consistent across assessment examinations. Some previous reports of sex differences in irritability, responsiveness, and f...

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supporting

confidence: 87%

“…Korner et al (1988) reported that preterm males were more frequently in states of sleep or waking activity (fussiness) at 34 weeks postconceptual age, whereas same-aged preterm females slept less than males and were more often in a quiet-awake state. These sex differences were also found to be consistent across assessment examinations.…”

Section: Articlementioning

confidence: 99%

Sex differences in neonatal state and lateralized head orientation

Michel

Harkins

Meserve

1990

Infant Behavior and Development

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“…One study, involving the analysis of sleep-wake behavior measures in preterm infants, demonstrates an area of application where a simple transformation to achieve normality is appealing, and interest lies in the random effect estimates of the fitted mixed model. The sleeping and waking states of preterm infants have been widely studied because these states are strongly associated with developmental outcomes later in life (Parmelee et al, 1967;Dreyfus, 1975;Korner et al, 1988;Holditch-Davis, 1990;Whitney and Thoman, 1993;Holditch-Davis and Edwards, 1998;Gertner et al, 2002). Identifying subjects with extreme values of these states is thus extremely important from both a research and a clinical perspective.…”

Section: Sleeping and Waking States Of Preterm Infants And Subsequentmentioning

confidence: 99%

Estimating Variance Components and Random Effects Using the Box-Cox Transformation in the Linear Mixed Model

Gurka

Edwards

2011

Communications in Statistics - Theory and Methods

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The linear mixed model assumes normality of its two sources of randomness: the random effects and the residual error. Recent research demonstrated that a simple transformation of the response targets normality of both sources simultaneously. However, estimating the transformation can lead to biased estimates of the variance components. Here, we provide guidance regarding this potential bias and propose a correction for it when such bias is substantial. This correction allows for accurate estimation of the random effects when using a transformation to achieve normality. The utility of this approach is demonstrated in a study of sleep-wake behavior in preterm infants.

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“…The evidence is limited, but some studies revealed state-related gender differences in preterm infants (Bach et al, 2000; Hoppenbrouwers et al, 2005; Korner et al, 1988). One study found females spending less time asleep, more time awake, and less waking activity throughout the early preterm period (Korner et al, 1988).…”

Section: Introductionmentioning

confidence: 99%

“…One study found females spending less time asleep, more time awake, and less waking activity throughout the early preterm period (Korner et al, 1988). Another study showed males having less sleep, more active sleep and less quiet sleep, and more frequent waking after sleep onset (Bach et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Individual and Gender Differences Matter in Preterm Infant State Development

Foreman

Thomas

Blackburn

2008

Journal of Obstetric, Gynecologic & Neonatal Nursing

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Objective-To further understand state development of preterm infants throughout hospitalization and the effects of selected infant characteristics on state development.Design-Secondary data analysis of a two-group, experimental design study. Setting-Two nurseries in a Northwest medical center.Participants-Ninety-seven (97) hospitalized, medically stable, preterm infants. Fifty one (51) subjects were females.Methods-Two hundred eighty five (285) real-time video recordings of infants performed during 4-hour interfeeding intervals. Sleep-wake states were coded at 15-second intervals.Results-Active sleep was the dominant state across postmenstrual ages. Although not statistically significant, preterm infants showed developmental changes in state organization with increased quiet sleep, drowsy, and awake, decreased active sleep, and more defined and less diffuse states over age. A significant gender effect was found, with males having less active sleep (p = .012), more drowsy (p = .03), more awake (p = 0.43), less defined (p = .002), and more diffuse (p = .001) states compared with females.Conclusion-The predominance of active sleep during the preterm period reflects level of brain maturation. The results emphasize individual variations in state organization influenced by endogenous and environmental factors. Gender differences are potential sources of individual variation.

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State behavior of preterm infants as a function of development, individual and sex differences

Cited by 29 publications

References 17 publications

Sex differences in neonatal state and lateralized head orientation

Sex differences in neonatal state and lateralized head orientation

Estimating Variance Components and Random Effects Using the Box-Cox Transformation in the Linear Mixed Model

Individual and Gender Differences Matter in Preterm Infant State Development

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