Sucking Behavior of Preterm Neonates As a Predictor of Developmental Outcomes

Objectives: The relationship between the pattern of sucking behavior of preterm infants during the early weeks of life and neurodevelopmental outcomes during the first year of life was evaluated. Methods: The study sample consisted of 105 preterm infants (postmenstrual age [PMA] at birth = 30.5 ± 2.8 weeks [mean ± SD]; birth weight = 1476 ± 460 g; mean length of hospital stay = 41.6 ± 31.4 days). All infants received a 5-minute sucking test at 34 and at 40 weeks PMA, with outcomes evaluated at 6 and/or 12 months corrected gestational age via the Bayley Scales of Infant Development. Results: As expected, 6- and 12-month values for the Psychomotor Developmental Index (PDI) and Mental Developmental Index (MDI) of the Bayley Scales of Infant Development were significantly below the normative levels established for infants delivered at term. A significant association between neonatal sucking pattern at 40 weeks PMA and developmental outcome at 12 months corrected gestational age was obtained. Each of the 3 simple sucking parameters evaluated (number of sucks, mean number of sucks per bursts and mean sucking pressure peaks), as well as a composite parameter (average of the respective parameter z-scores), was significantly related to both PDI and MDI at 12 months. Conclusions: Multivariable models, adjusting for PMA at birth, length of hospital stay, and other predictors, affirmed that sucking performance at 40 weeks PMA was a significant, independent predictor of developmental status 1 year later. Standardization of an instrument for neonatal sucking assessment may offer a cost-effective early screening strategy for preterm infants at greatest risk for developmental delay.

[1]  C. Lau,et al.  Coordination of suck‐swallow and swallow respiration in preterm infants , 2003, Acta paediatrica.

[2]  F. Duffy,et al.  Behavioral differences between preterm and full-term newborns as measured with the APIB system scores: I , 1988 .

[3]  Christopher J. Cannistraci,et al.  Regional brain volume abnormalities and long-term cognitive outcome in preterm infants. , 2000, JAMA.

[4]  M. Mirmiran,et al.  Neurobehavioral Assessment Predicts Differential Outcome Between VLBW and ELBW Preterm Infants , 2005, Journal of Perinatology.

[5]  Amy L. Salisbury,et al.  Prenatal cocaine use and maternal depression: effects on infant neurobehavior. , 2007, Neurotoxicology and teratology.

[6]  T. Inder,et al.  White matter injury in the premature infant: a comparison between serial cranial sonographic and MR findings at term. , 2003, AJNR. American journal of neuroradiology.

[7]  J. Bosma,et al.  Integration of suck and swallow rhythms during feeding in preterm infants with and without bronchopulmonary dysplasia. , 2003, Developmental medicine and child neurology.

[8]  F. C. Bennett,et al.  Outcome of infants weighing less than 800 grams at birth: 15 years' experience. , 1995, Pediatrics.

[9]  K. Mizuno,et al.  Development of sucking behavior in infants who have not been fed for 2 months after birth , 2001, Pediatrics international : official journal of the Japan Pediatric Society.

[10]  P. Wolff,et al.  The serial organization of sucking in the young infant. , 1968, Pediatrics.

[11]  Debra E Weese-Mayer,et al.  Sleep architecture in term and preterm infants beyond the neonatal period: the influence of gestational age, steroids, and ventilatory support. , 2005, Sleep.

[12]  A. Bos,et al.  Sucking and swallowing in infants and diagnostic tools , 2008, Journal of Perinatology.

[13]  K. Mizuno,et al.  The maturation and coordination of sucking, swallowing, and respiration in preterm infants. , 2003, The Journal of pediatrics.

[14]  M. Belyea,et al.  Prediction of 3-year developmental outcomes from sleep development over the preterm period , 2005 .

[15]  N. Bayley.  Manual for the Bayley Scales of Infant Development , 1969 .

[16]  A. Eidelman,et al.  Cerebral Blood Flow Velocity Asymmetry, Neurobehavioral Maturation, and the Cognitive Development of Premature Infants Across the First Two Years , 2007, Journal of developmental and behavioral pediatrics : JDBP.

[17]  J. Bosma,et al.  Abnormal developmental patterns of suck and swallow rhythms during feeding in preterm infants with bronchopulmonary dysplasia , 2001, Developmental medicine and child neurology.

[18]  E. Thoman,et al.  Sleep rhythmicity in premature infants: implications for development status. , 1995, Sleep.

[19]  B. Medoff‐Cooper,et al.  Changes in nutritive sucking patterns with increasing gestational age. , 1991, Nursing research.

[20]  Edward C. Chao,et al.  Generalized Estimating Equations , 2003, Technometrics.

[21]  J. Shults,et al.  Feeding Patterns of Full-Term and Preterm Infants at Forty Weeks Postconceptional Age , 2002, Journal of developmental and behavioral pediatrics : JDBP.

[22]  M. Eiselt,et al.  Sleep State Organization in Premature Infants of Less Than 35 Weeks' Gestational Age , 1993, Pediatric Research.

[23]  L. Doyle,et al.  Neurodevelopmental sequelae of intraventricular haemorrhage at 8 years of age in a regional cohort of ELBW/very preterm infants. , 2005, Early human development.

[24]  H G Vaughan,et al.  Cognitive and neurologic development of the premature, small for gestational age infant through age 6: comparison by birth weight and gestational age. , 1996, Pediatrics.

[25]  Todd Schwartz,et al.  Sleeping and waking state development in preterm infants. , 2004, Early human development.

[26]  L. Lagasse,et al.  Prenatal methamphetamine use and neonatal neurobehavioral outcome. , 2008, Neurotoxicology and teratology.

[27]  David L. Banks,et al.  Functional brain maturation in neonates as measured by EEG-sleep analyses , 2003, Clinical Neurophysiology.

[28]  W. Carlo,et al.  Bronchopulmonary dysplasia: new insights. , 2004, Clinics in perinatology.

[29]  W. Bilker,et al.  Suckling behavior as a function of gestational age: A cross-sectional study? 1 1 ? This study was su , 2001 .

[30]  B. Lester,et al.  History and description of the Neonatal Intensive Care Unit Network Neurobehavioral Scale. , 2004, Pediatrics.