Preterm infants' early developmental status is associated with later developmental outcome.

AIM: To assess the development of preterm infants from 40 weeks gestational age to 18 months corrected age to identify early predictors of later development. METHODS: Fifty-one infants were involved. Infant development was assessed at 40 and 44 weeks gestational age with the Brazelton neonatal behavioral assessment scale and a self-regulation scale and at 3, 6, 10, 18 months corrected age with the Bayley Scales of Infant Development. The quality of general movements was assessed at 1 and 3 months corrected age and maternal attachment style at infant's age of 6 months corrected age with the Relation Scale Questionnaire. RESULTS: At term age and 1-month corrected age, preterm infants were less mature and had lower levels of self-regulation than full-term infants. At 3 months corrected age, a higher proportion of preterm infants (43%) had mildly abnormal motor quality compared to the general population (25%). At all follow-ups, preterm infants had delayed mental, motor and behavioural development, which was associated with the level of self-regulation, motor quality and maternal attachment style. Maternal education level was the most predominant background factor related to infant development. CONCLUSION: Preterm infants show early-in-life deviations in self-regulation, motor quality and development. These deviations are risk factors for later optimal functioning.

Early behaviour and development in breast-fed premature infants are influenced by omega-6 and omega-3 fatty acid status.

BACKGROUND: The requirement of essential fatty acids (EFA) for the development of the brain is well documented. OBJECTIVE: To investigate the early neurological development at term and 44 weeks gestational age in preterm infants in relation to EFA concentrations in breast milk and in infants' and mothers' plasma phospholipids. METHOD: Fifty-one premature infants and their mothers were consecutively included in the study. The median gestational age was 34 weeks (range 24-36). The motor quality, motor and behavioural development were assessed by General Movements (GMs), the Brazelton Neonatal Behavioral Assessment Scale (BNBAS) and a Self Regulation Scale. RESULTS: Mother's education and gestational age correlated to several outcome variables. Multiple regression with correction for background factors showed negative associations between early breast milk concentrations of Mead acid and GMs and between AA and the BNBAS clusters Orientation and Range of States, respectively. Between 40 and 44 weeks gestational age, no expected increased scores were observed for Regulation of States, Range of States and Self Regulation. During the corresponding time, increased concentration of linoleic acid in mothers' plasma was negatively associated with improvement in Orientation and increased concentration of EPA in the infants' plasma was positively associated with improvement in Autonomic Stability. CONCLUSIONS: The major omega-6 fatty acids and Mead acid were negatively associated with early development and omega-3 fatty acids positively associated. Mother's education and the gestational age influenced the outcome more strongly than mother's and infant's morbidities. Further follow-up will elucidate the significance of these early findings.