Neonatal pattern vision: a predictor of future mental performance?

The visual fixation responses of 33 high-risk neonates to patterned stimuli were rated as normal, suspect, or abnormal in an attempt to predict future intellectual performance. For comparison purposes, a neurologic examination was aslo administered. Follow-up studies based on autopsies and neurologic and psychological testing agreed with the neonatal visual preference ratings in 27 cases, but with the neurologic examination ratings in only 22 cases. This preliminary study suggests that neonatal visual testing is a promising technique for evaluating brain integrity in the newborn period.

The effect of a low continuous positive airway pressure on the reflex control of respiration in the preterm infant.

The airway occlusion technique was used to measure the strength of the Hering-Breuer inflation reflex before and during the administration of low pressure CPAP. In five of 12 preterm infants studied in the first two weeks of life, CPAP did not alter the inflation reflex. In the other seven premature infants, shortened rather than lengthened inspiratory efforts were observed on occlusion 32 times of CPAP but only twice on CPAP. In seven term infants at 1 to 2.5 hours of age this shortening was noted only twice in 58 occlusions. In the preterm infants exhibiting short responses, the peak inspiratory pressure generated in response to occlusion rose on CPAP from 3.4 to 7.1 cm H2O (p less than 0.005), while respiratory rate fell from 61 to 49 breaths/minute (p less than 0.025). This data suggests that CPAP enhances these infants' ability to adjust to increased respiratory loads, possibly by the elimination of a Hering-Breuer deflation reflex.

Urinary biogenic amines in idiopathic apnea of prematurity.

Urinary biogenic amines were measured in 22 preterm infants of less than 36 weeks' gestational age. Fifteen of these infants had idiopathic apnea. Although levels of urinary dopa were not significantly different, dopamine, norepinephrine and epinephrine were all significantly lower in the infants with apena. It is proposed that apnea of prematurity may be related to an immaturity of catecholamine-producing pathways, leading to inadequate physiologic responses to hypoxia, with resulting accentuation of central respiratory depression. Alternatively, urinary biogenic amines may be a reflection of some unrelated process occurring elsewhere in the body or a depletion of catechol stores resulting from the apnea itself.

Apnea of prematurity. Comparative therapeutic effects of cutaneous stimulation and nasal continuous positive airway pressure.

It has been suggested that idiopathic apnea of prematurity is related to hypoxia from pulmonary instability or an immaturity of central respiratory control mechanisms. To explore these hypotheses, 18 preterm infants were studied to examine the therapeutic effects of prophylactic cutaneous stimulation (6) and continuous positive airway pressure(12). The frequency of apnea using each procedure was reduced by 35 and 69 percent, respectively. These findings constitute the basis for new therapeutic measures for treatment of idiopathic neonatal apnea.

Does human maternal behaviour after delivery show a characteristic pattern?

Specific kinds of maternal behaviour such as nesting, retrieving, grooming and exploring, are seen in non-human mammalian mothers immediately before, during and after delivery. In this study 22 human mothers were filmed during the first 10 minutes of contact with their normal nude full-term infants, who were placed beside them in private rooms in hospitals in Guatemala and the US; and nine mothers of premature infants were filmed on their first three visits to the nursery. Another 10 Guatemalan mothers and infants were observed for 10 minutes almost immediately after delivery in hospital. These observations were compared to maternal behaviour after home deliveries in California. After hospital delivery all US mothers, but only half of the Guatemalans, began touching their infants' extremities with their fingertips and proceeded within a few minutes to palm contact on the trunk. US mothers had an intense interest in eye-to-eye contact. Mothers of premature infants showed only fragments of this behaviour. In home births when the mothers are active participants in delivery, they pick up the infant immediately after birth, stroke its face with their fingertips and start breast-feeding within the first minutes after delivery. Initially the infant only licks the nipples. there is striking elevation in mood in the parents. These observations focus attention on reciprocal behaviour patterns that develop early between mother and infant and which serve to unite them.

Evidence for a sensitive period in the human mother.

In certain animal species immediate separation of a mother from here young for a brief period after deliver (the sensitive period) may result in aberrant maternal behaviour. In the human, disorders of mothering, including child abuse, increase disproportionately in situations associated with early neonatal separation of mother and infant, such as prematurity. Mothers in the United States who were offered early contact with their premature infants showed differences in attachment behaviour when compared with mothers whose first contact with their infants was three weeks after delivery. Mothers who had one hour of close physical contact with their nude full-term infants within the first two hours after delivery and who had 15 extra hours of contact in the frist three days behaved significantly differently during a physical examination of the infant at one month and one year, and in their speech to their infants at two years, from a control group of mothers who had only routine contact. In a similar study in Guatemala, mothers who had 45 minutes of early extra contact showed significantly more attachment behaviour at the time of the first breast-feeding (12 hours). These and other studies in the human suggest that shortly after birth there is a sensitive period which appears to have long-lasting effects on maternal attachment and which may ultimately affect the development of the child.

Mother-to-child speech at 2 years--effects of early postnatal contact.

Ten primiparous mothers were randomly selected from two groups of women who had spent different amounts of time with their newborn infants. The speech behavior of the mothers in the two groups was compared while they were addressing their 2-year-old children in an informal play situation. Speech patterns of the mothers revealed that those who had been given extra contact with their infants during the neonatal period used significantly more questions, adjectives, words per proposition, and fewer comands and content words than did the control mothers. These observations suggest that the linguistic behavior of the young child may be shaped by hospital-care practices for mother and her infant.