Roberta G Pineda1, Lauren C Reynolds2, Kristin Seefeldt3, Claudia L Hilton4, Cynthia L Rogers5, Terrie E Inder6. 1. Roberta G. Pineda, PhD, OTR/L, is Assistant Professor, Program in Occupational Therapy and Department of Pediatrics, Washington University School of Medicine, St. Louis, MO; pineda_r@kids.wustl.edu. 2. Lauren C. Reynolds, OTD, OTR/L, is Research Coordinator, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO. 3. Kristin Seefeldt, OTR/L, is Occupational Therapist, The Lighthouse Neurological Rehabilitation Center, Kingsley, MI. 4. Claudia L. Hilton, PhD, OTR, is Assistant Professor, Department of Occupational Therapy and Department of Rehabilitation Sciences, University of Texas Medical Branch, Galveston. 5. Cynthia L. Rogers, MD, is Assistant Professor, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO. 6. Terrie E. Inder, MD, PhD, is Chair, Department of Pediatric Newborn Medicine, Brigham and Women's Infant Hospital, Boston, MA.
Abstract
OBJECTIVE: To investigate changes in head lag across postmenstrual age and define associations between head lag and (1) perinatal exposures and (2) neurodevelopment. METHOD: Sixty-four infants born ≤ 30 wk gestation had head lag assessed before and at term-equivalent age. Neurobehavior was assessed at term age. At 2 yr, neurodevelopmental testing was conducted. RESULTS: Head lag decreased with advancing postmenstrual age, but 58% (n = 37) of infants continued to demonstrate head lag at term. Head lag was associated with longer stay in the neonatal intensive care unit (p = .009), inotrope use (p = .04), sepsis (p = .02), longer endotracheal intubation (p = .01), and cerebral injury (p = .006). Head lag was related to alterations in early neurobehavior (p < .03), but no associations with neurodevelopment were found at 2 yr. CONCLUSION: Head lag was related to medical factors and early neurobehavior, but it may not be a good predictor of outcome when used in isolation.
OBJECTIVE: To investigate changes in head lag across postmenstrual age and define associations between head lag and (1) perinatal exposures and (2) neurodevelopment. METHOD: Sixty-four infants born ≤ 30 wk gestation had head lag assessed before and at term-equivalent age. Neurobehavior was assessed at term age. At 2 yr, neurodevelopmental testing was conducted. RESULTS: Head lag decreased with advancing postmenstrual age, but 58% (n = 37) of infants continued to demonstrate head lag at term. Head lag was associated with longer stay in the neonatal intensive care unit (p = .009), inotrope use (p = .04), sepsis (p = .02), longer endotracheal intubation (p = .01), and cerebral injury (p = .006). Head lag was related to alterations in early neurobehavior (p < .03), but no associations with neurodevelopment were found at 2 yr. CONCLUSION: Head lag was related to medical factors and early neurobehavior, but it may not be a good predictor of outcome when used in isolation.