Rapid eye movement (REM) in premature neonates and developmental outcome at 6 months.

Department of Psychology and the Gonda Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel.
Infant behavior & development (Impact Factor: 1.34). 12/2008; 32(1):27-32. DOI: 10.1016/j.infbeh.2008.09.001
Source: PubMed

ABSTRACT Different aspects of early sleep organization have been associated with subsequent development in premature infants. The aim of the present study was to assess the relations between rapid eye movement (REM) activity in premature neonates and infants' developmental outcomes at 6 months. Participants were 81 premature infants (47 males). Sleep-wake states and REM were observed across 4 consecutive evening hours (7-11 PM) in 10-s frames when infants were between 32 and 36 weeks post-menstrual age. Developmental outcome was assessed at 6 months with the mental development index (MDI) of the Bayley II. Infants with low-REM activity spent more time in less growth-promoting states, including crying and unfocused alert states in the neonatal period and had lower MDI scores at 6 months corrected age compared to infants with high-REM. Differences between the high- and low-REM groups were independent of neonatal medical risk. Low-REM activity may serve as an indicator of developmental risk among premature neonates.

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    ABSTRACT: Topic Sleeping behaviour Introduction Behaviour is the only way infants can communicate their needs to parents and other caregivers. Clinicians use changes in infant behaviours to alert them to possible medical complications that need further investigation, 1 and researchers use specific infant behaviours to identify pain 2 and responses to interventions that modify neonatal care. 3 Sleeping and waking not only affect the infant's immediate response to stimulation but, because they reflect the functioning of the central nervous system, have also been found to be related to developmental outcomes. 4-8 Subject More than 12% of births in the U.S. are premature (less than 37 weeks of gestation). The sleep of premature infants differs from that of full-term infants. These differences may continue after the neonatal hospitalization. Problem Sleeping and waking behaviours affect the development of preterm infants in multiple ways. First, sleeping and waking affect the infant's ability to respond to stimulation. Second, infants with neurological problems exhibit abnormal sleep patterns. Sleep and wakefulness may also have direct effects on brain development and learning that continue after the infant has been discharged home. Finally, differences in the sleep-wake patterns of preterm infants as compared to those of full-term infants might lead to sleep problems after hospital discharge. Key Research Questions Research is needed to describe the development of sleep and waking in preterm infants and to examine factors in the hospital and home environment that affect this development, the relationship between sleep development in preterm infants and other areas of psychosocial development, and to determine the extent to which sleep of prematurely born children continues to differ from that of children born at term after infancy and the degree to which these differences are related to sleep problems.
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    ABSTRACT: Introduction Le comportement est le seul moyen dont disposent les bébés pour communiquer leurs besoins à leurs parents et aux personnes qui s'occupent d'eux. Les cliniciens se fondent sur les changements de comportement des nouveau-nés pour pressentir d'éventuelles complications médicales qui nécessiteraient une analyse plus poussée, 1 et les chercheurs étudient les comportements particuliers de certains bébés pour déterminer la douleur 2 et les réactions aux interventions qui modifient les soins néonataux. 3 Le sommeil et l'état d'éveil influent sur la réaction immédiate du bébé à la stimulation. Par ailleurs, comme ils reflètent le fonctionnement du système nerveux central, il a été prouvé qu'ils ont également une incidence sur le développement. 4-8 Sujet Aux États-Unis, plus de 12% des naissances sont prématurées (elles se produisent à moins de 37 semaines de grossesse). Le sommeil des prématurés diffère de celui des bébés nés à terme et il arrive que cette différence persiste après l'hospitalisation néonatale. Problèmes Les comportements des prématurés pendant les périodes d'éveil et de sommeil influent sur leur développement de multiples façons. D'abord, le sommeil et l'état d'éveil ont une incidence sur la capacité du bébé de réagir à la stimulation. De plus, les nouveau-nés aux prises avec des problèmes neurologiques présentent des cycles de sommeil anormaux. Le sommeil et l'état d'éveil peuvent également avoir des effets directs sur le développement du cerveau et l'apprentissage des effets directs qui continueront de se manifester une fois le bébé à la maison. Finalement, les différences dans les cycles de veille-sommeil des prématurés par rapport à ceux des bébés nés à terme pourraient être associés à des problèmes de sommeil après la sortie de l'hôpital.
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    ABSTRACT: AIM: To study the impact on newborn behavioural states and accuracy of three infrared thermometers compared with digital axillary thermometer measurements in very low birth weight infants. METHODS: Single-centre prospective observational study. Preterm infants born <1500-g birth weight were eligible. Infants were observed for pre-measurement behaviour state using a five-point neonatal behaviour observation tool. One infrared temperature was taken from each of the devices, followed by an axillary measurement. Further behaviour-state observations were recorded following infrared and axillary measurements. RESULTS: One hundred measurements were collected from each infrared device among a cohort of 42 very low birth weight infants. Only one infrared device showed satisfactory agreement with bias -0.071 (95% limits of agreement -0.68 to 0.54). The other two devices demonstrated poor agreement: bias -1.34; 95% limits of agreement -2.62 to -0.5 and bias -0.56; 95% limits of agreement -1.38 to 0.25. Neonatal behavioural scores showed only minimal changes when infrared measurements were performed but increased significantly following axillary measurements. The difference between the two modalities was statistically significant with a mean increase of 1.44 points following axillary measurements (95% confidence interval 1.21 to 1.67, P < 0.001). CONCLUSIONS: Temperature measurements taken with infrared thermometers demonstrated less disruption to preterm infants' behavioural state, however accuracy of devices varied.
    Journal of Paediatrics and Child Health 04/2013; 49(6). DOI:10.1111/jpc.12207 · 1.19 Impact Factor


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May 21, 2014