SEARCH · PubMed Health

Results for “Infant Development”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 487 records · Page 27Linked to original sources

PubMed2000

Diuretics acting on the distal renal tubule for preterm infants with (or developing) chronic lung disease.

OBJECTIVES: The aim of this review is to assess the risks and benefits of diuretics acting on distal segments of the renal tubule (distal diuretics) in preterm infants with or developing chronic lung disease (CLD). Primary objectives are to assess changes in need for oxygen or ventilatory support and effects on long-term outcome, and secondary objectives are to assess changes in pulmonary mechanics and potential complications of therapy. SEARCH STRATEGY: We used the standard method of the Cochrane Neonatal Review Group. We used the following keywords: ¿ or ¿ and , limited to and limited to or . We searched Medline (1966-1998), Embase (1974-1998) and the Cochrane Controlled Trials Register (CCTR) from the Cochrane Library (1999, issue 2). In addition, we hand searched several abstract books of national and international American and European Societies. SELECTION CRITERIA: We included in this analysis trials in which preterm infants with or developing CLD and at least five days of age were all randomly allocated to receive a distal diuretic (i.e., a diuretic acting on the distal renal tubule). Eligible studies needed to assess at least one of the outcome variables defined a priori for this systematic review. Primary outcome variables included changes in need for respiratory support and oxygen supplementation, mortality, bronchopulmonary dysplasia (BPD), death or BPD, chronic lung disease at 36 weeks of postconceptional age (gestational age + postnatal age), length of stay, and number of rehospitalizations during the first year of life. Secondary outcome variables included pulmonary mechanics and potential complications of therapy. DATA COLLECTION AND ANALYSIS: We used the standard method for the Cochrane Collaboration which is described in the Cochrane Collaboration Handbook. Two investigators extracted, assessed and coded separately all data for each study, using a form that was designed specifically for this review. Any disagreement was resolved by discussion. We combined parallel and cross-over trials and, whenever possible, transformed baseline and final outcome data measured on a continuous scale into change scores using Follmann's formula. MAIN RESULTS: Of six studies fulfilling entry criteria, most focused on pathophysiological parameters and did not assess effects on important clinical outcomes defined in this review, or the potential complications of diuretic therapy. In preterm infants > 3 weeks of age with CLD, a four-week treatment with thiazide and spironolactone improved lung compliance and reduced the need for furosemide. Thiazide and spironolactone decreased the risk of death and tended to decrease the risk for lack of extubation after 8 weeks in intubated infants. There is no evidence to support the hypothesis that adding spironolactone to thiazide or that adding metolazone to furosemide improves the outcome of preterm infants with CLD. REVIEWER'S CONCLUSIONS: In preterm infants > 3 weeks of age with CLD, acute and chronic administration of distal diuretics improve pulmonary mechanics. Chronic administration of diuretics (thiazide with spironolactone) reduces mortality in intubated patients. Large studies are needed to assess (1) whether chronic diuretic administration improves mortality, duration of oxygen dependency, ventilator dependency, length of hospital stay and long-term outcome in patients without long-term toxicity and (2) whether adding spironolactone to thiazides or adding metolazone to furosemide has any beneficial effect.

Chronic Disease↗

PubMed2007

The development of infant discrimination of affect in multimodal and unimodal stimulation: The role of intersensory redundancy.

This research examined the developmental course of infants' ability to perceive affect in bimodal (audiovisual) and unimodal (auditory and visual) displays of a woman speaking. According to the intersensory redundancy hypothesis (L. E. Bahrick, R. Lickliter, & R. Flom, 2004), detection of amodal properties is facilitated in multimodal stimulation and attenuated in unimodal stimulation. Later in development, however, attention becomes more flexible, and amodal properties can be perceived in both multimodal and unimodal stimulation. The authors tested these predictions by assessing 3-, 4-, 5-, and 7-month-olds' discrimination of affect. Results demonstrated that in bimodal stimulation, discrimination of affect emerged by 4 months and remained stable across age. However, in unimodal stimulation, detection of affect emerged gradually, with sensitivity to auditory stimulation emerging at 5 months and visual stimulation at 7 months. Further temporal synchrony between faces and voices was necessary for younger infants' discrimination of affect. Across development, infants first perceive affect in multimodal stimulation through detecting amodal properties, and later their perception of affect is extended to unimodal auditory and visual stimulation. Implications for social development, including joint attention and social referencing, are considered.

Affect↗

PubMed1993

Influence of socioeconomic and health care development on infant and perinatal mortality in Spain 1975-86.

STUDY OBJECTIVE: This study aimed to analyse the influence of social, economic, and health development on infant and perinatal mortality in Spain between 1975 and 1986, and to identify possible changes in these relationships over time. DESIGN: Study of the association between mortality and a range of variables. SETTING: 50 Spanish provinces. MEASUREMENTS AND MAIN RESULTS: Mean infant and perinatal mortality were estimated for two periods--1975-8 and 1983-6. Social, economic, and health care indicators were collected as independent variables for these two periods. The rates of variation between periods were estimated for each variable. Multiple linear regression models were used to define the association between infant and perinatal mortality and their respective rate of variation with the former indicators. Mean familial income was the main predictive factor for infant and perinatal mortality in the first period but in the second period health care indicators were more relevant. CONCLUSIONS: The reduction in Spanish infant and perinatal mortality over the period can be attributed mainly to the improvement in prenatal and neonatal health care in Spain in recent years, while economic factors seem less important.

Birth Rate↗

PubMed2004

Plasma 8-isoprostane is increased in preterm infants who develop bronchopulmonary dysplasia or periventricular leukomalacia.

Our aim was to assess the plasma free 8-epi-prostaglandin F(2alpha) (8-isoprostane) and ascorbyl radical as risk indicators for oxidative damage in extremely low birth weight infants (ELBWIs) and the effect of N-acetylcysteine (NAC) on these markers. Plasma samples were collected on days 3 and 7 of life from infants who were enrolled in a randomized, controlled trial in which i.v. NAC or placebo was administered to ELBWIs during the first week of life, with the aim of preventing bronchopulmonary dysplasia (BPD). Plasma 8-isoprostane was analyzed in 83 infants using an enzyme immunoassay kit. Ascorbyl radical concentration was measured in 61 infants with electron spin resonance spectroscopy. The 8-isoprostane concentrations were similar in the NAC and placebo groups. In infants who later developed BPD or died (n = 29), the median (range) 8-isoprostane concentration was significantly higher (p = 0.001) on day 3 and day 7 [50.0 pg/mL (19-360) and 57.0 pg/mL (14-460), respectively] than in survivors without BPD [n = 54; 34.5 pg/mL (5-240) and 39.5 pg/mL (7-400), respectively]. The 8-isoprostane levels increased significantly more (p < 0.05) in infants who later developed periventricular leukomalacia. NAC treatment or the later development of BPD was not related to the ascorbyl radical levels. The ascorbyl radical level decreased significantly in all groups from day 3 to day 7, but the difference between the groups was not significant. The mean (SD) ascorbyl radical level on day 3 was significantly higher (p < 0.01) in infants who later developed periventricular leukomalacia [287 (124) versus 194 (90)]. These data suggest that plasma 8-isoprostane could serve as a marker in assessing the risk for BPD development in ELBWIs.

Biomarkers↗

PubMed2005

Effect of congenital heart disease on neurodevelopmental outcomes within multiple-gestation births.

OBJECTIVES: We sought to assess the effect of congenital heart disease requiring surgical intervention with cardiopulmonary bypass at 6 months of age or less on developmental outcomes and growth at 1 year of age while controlling for socioeconomic status, prematurity, home environment, and parental intelligence. METHODS: We performed within-family comparison of 11 multiple-gestation births in which one child had congenital heart disease. At 1 year of age, the Bayley Scales of Infant Development II were administered, and growth parameters were assessed. Paired comparisons were made by using fixed effects regression conditioned on family. RESULTS: The multiple-gestation subjects were mildly premature on average (mean gestational age, 35.4 +/- 3.0 weeks). At 1 year of age, children with congenital heart disease scored lower on the Mental Development Index (85.0 +/- 19.3 vs 93.9 +/- 16.0, P = .037) and the Psychomotor Development Index (76.6 +/- 16.9 vs 91.3 +/- 14.9, P = .015) on the Bayley Scales of Infant Development II than did their siblings without congenital heart disease. There were no differences between siblings in weight, height, or head circumference. CONCLUSIONS: The presence of congenital heart disease requiring surgical intervention with cardiopulmonary bypass at 6 months of age or less is associated with a deficit in developmental achievement at 1 year of age, as measured by using the Bayley Scales of Infant Development II.

Female↗

PubMedDate not supplied

Characterization of the consistency of gruels consumed by infants in developing countries: assessment of the Bostwick consistometer and comparison with viscosity measurements and sensory perception.

Standardized techniques are still needed to characterize the consistency of gruels for infants in developing countries. The aim of this study was to evaluate the interest of the use of the Bostwick consistometer. Bostwick flow was measured on gruels prepared with different flours, at low or high energy density (i.e. without or with amylase). The range of Bostwick flow, from 0 to 240 mm/30 sec, adequately described a wide range of gruel consistencies from completely liquid to almost solid. However, the temperature of the gruel must be carefully controlled during measurements as Bostwick flow is highly temperature dependent, especially in the case of gruels with high energy density. The relationship between Bostwick flow and apparent viscosity proved to depend on the type of gruel: at an apparent viscosity of 1 Pa.sec, gruels prepared from maize, rice, millet or multicomponent flours had different Bostwick flow values of, respectively, 20, 35, 75 and 55 mm/30 sec. Sensory analysis was then performed with a panel of mothers of infants and young children in Ouagadougou (Burkina Faso). Gruels of similar apparent viscosity and different Bostwick flow distances or of inversely similar Bostwick flow distances and different apparent viscosities were prepared by adding carob seed flour, and differentiation and ranking tests were then carried out. Both types of test revealed that mothers differentiated similar gruels having different Bostwick flow distances more easily than gruels having different apparent viscosities. It can thus be concluded that Bostwick flow, which is an empirical multi-criteria parameter, conveys the sensory perception of gruel consistency better than apparent viscosity.

Adult↗

PubMed2006

Supplementation of fish-oil and soy-oil during pregnancy and psychomotor development of infants.

Supplementation of docosahexaenoic acid (DHA) in infancy improves neuro-developmental outcomes, but there is limited information about the impact of supplementing pregnant mothers with DHA on the development of their infants. In a follow-up of a randomized, double-blind controlled trial with 400 pregnant mothers, the effects of supplementation of fish-oil or soy-oil (4 g/day) during the last trimester of pregnancy on psychomotor development and behaviour of infants at 10 months of age (n=249) were assessed. The quality of psychosocial stimulation at home (HOME) and nutritional status of the subjects were also measured. There were no significant differences in the fish-oil group and soy-oil group in any of the developmental (mean +/-SD mental development index: 102.5 +/- 8.0 vs. 101.5 +/- 7.8, psychomotor development index: 101.7 +/- 10.0 vs. 100.5 +/- 10.1) or behavioural outcomes. It may, therefore, be concluded that supplementation of fish-oil during the last trimester of pregnancy does not have any added benefit over supplementation of soy-oil on the development or behaviour of infants in this population.

Adult↗

PubMed1988

Growth and development of infants with end-stage renal disease receiving long-term peritoneal dialysis.

The growth and development of four infants with end-stage renal disease receiving long-term peritoneal dialysis was studied during the first year of life. In each patient, dialysis was begun before 4 weeks of age. A nutritional regimen was designed to attain a daily weight gain appropriate for height age while minimizing the blood urea nitrogen level. A neurodevelopmental evaluation of gross and fine motor, cognitive, language, and psychosocial skills was performed at least every 3 months. At age 1 year, the mean height standard deviation score (SDS) was -1.33 +/- 0.2. Weight for height was greater than 95th percentile in one patient and normal in three. Mean caloric and protein intake were 105 +/- 20 kcal/kg/d (11.4 +/- 2.7 kcal/cm/d) and 2.7 g/kg/d (0.30 +/- 0.11 g/cm/d), respectively. Mean blood urea nitrogen was 53.6 +/- 17.8 mg/dL. Developmentally, three of the patients were functioning in the normal range and one was mildly retarded. However, gross motor skills were delayed in all patients. Although infants with end-stage renal disease are usually severely growth retarded and developmentally delayed, our observations suggest that early nutritional intervention and dialysis can yield improved results.

Blood Urea Nitrogen↗

PubMed2002

Airway complications in neonates who received mechanical ventilation.

OBJECTIVE: To determine the incidence, type and severity of airway complications in high risk neonates who received conventional mechanical ventilation. METHOD: Forty-five infants who had received conventional mechanical ventilation in the Neonatal Intensive Care Unit, Department of Pediatrics, Faculty of Medicine Siriraj Hospital for at least 4 days were enrolled. Orotracheal intubation with blue line, non-cuffed, non-shouldered polyvinylchloride tube was used exclusively. The average number of intubations was 2 (range 1-7), and the average duration for intubation was 25 days. The details of the intubation, and the presence of respiratory distress after extubation were recorded. All of the infants had endoscopic examination of the airway within 5 days of extubation. RESULTS: Following extubation, 14 (31.1%) infants developed signs of upper airway obstruction, of which inspiratory dyspnea was the most common manifestation. Only 4 infants developed inspiratory stridor, three of them had a birth weight greater than 2,500 g. Abnormal bronchoscopic findings were found in 42 infants, 68.8 per cent had multiple sites of injury. Supraglottic lesions were found in 55.7 per cent of cases. Laryngomalacia was an associated finding in 8 and gastroesophageal reflux (GER) in 1 occasion. CONCLUSIONS: From the result of this study, the authors found that airway complications related to endotracheal intubation are common among survivors from the Neonatal Intensive Care Unit. When the diagnosis of airway complications only depends on symptoms and signs of upper airway obstruction, the incidence and extent of injuries may be under-estimated. When attempted extubation fails or when VLBW infants develop increasing respiratory distress that is not clearly explained by an apparent disorder involving the pulmonary parenchyma, flexible bronchoscopic examination should be performed at the bedside with minimal risk.

Airway Obstruction↗

PubMed1993

Development of infant contrast sensitivity to chromatic stimuli.

We have monitored the development of contrast sensitivity to equiluminant red-green chromatic patterns by monitoring visual evoked potentials (VEPs) in 13 infants. The results confirm our previous report [Morrone, Burr and Fiorentini, Proceedings of the Royal Society B, 242 (1990a)] that, before 7-8 weeks of age, there was no response to purely chromatic stimuli, while at the same age luminance stimuli of 20% contrast produced reliable responses. At all ages (even before the onset of a chromatic response) the colour mixture to yield equiluminance was similar to that of adults, suggesting that the relative proportion and efficacy of medium- and long-wave cones is similar for infants as for adults. For both luminance and chromatic stimuli, amplitude increased roughly linearly with log-contrast, so sensitivity thresholds could be predicted by linear extrapolation to the abscissa. Detailed contrast sensitivity curves were measured for four infants at various ages. The results show that luminance and chromatic contrast sensitivity develop independently at different rates, probably reflecting differential development of postreceptoral neural mechanisms.

Age Factors↗

PubMed2003

Maternal hypothyroxinaemia during early pregnancy and subsequent child development: a 3-year follow-up study.

OBJECTIVE: To evaluate the impact of maternal hypothyroxinaemia during early gestation (fT4 below the lowest tenth percentile and TSH within the reference range: 0.15-2.0 mIU/l) on infant development, together with any subsequent changes in fT4 during gestation. DESIGN: A prospective 3-year follow-up study of pregnant women and their children up to the age of 2 years. MEASUREMENTS: Child development was assessed by means of the Bayley Scales of Infant Development in children of women with hypothyroxinaemia (fT4 below the tenth percentile at 12 weeks' gestation) at 12 weeks' gestation (cases), and in children of women with fT4 between the 50th and 90th percentiles at 12 weeks' gestation, matched for parity and gravidity (controls). Maternal thyroid function (fT4 and TSH) was assessed at 12, 24 and 32 weeks' gestation. The mental and motor function of 63 cases and 62 controls was compared at the age of 1 year, and of 57 cases and 58 controls at the age of 2 years. RESULTS: Children of women with hypothyroxinaemia at 12 weeks' gestation had delayed mental and motor function compared to controls: 10 index points on the mental scale (95% CI: 4.5-15 points, P = 0.003) and eight on the motor scale at the age of 1 year (95% CI: 2.3-12.8 points, P = 0.02), as well as eight index points on the mental (95% CI: 4-12 points, P = 0.02), and 10 on the motor scale (95%CI: 6-16 points, P = 0.005) at the age of 2 years. Children of hypothyroxinaemic women in whom the fT4 concentration was increased at 24 and 32 weeks' gestation had similar scores to controls, while in the controls, the developmental scores were not influenced by further declines in maternal fT4 at 24 and 32 weeks' gestation. CONCLUSIONS: Maternal hypothyroxinaemia during early gestation is an independent determinant of a delay in infant neurodevelopment. However, when fT4 concentrations increase during pregnancy in women who are hypothyroxinaemic during early gestation, infant development appears not to be adversely affected.

Adult↗

PubMed2003

Impact of cleft lip and/or palate on nutritional health and oral-motor development.

Infants born with a cleft may require modifications in feeding practices prior to surgical closure of the defect; however, few changes in dietary recommendations are necessary. Often, the delivery method of breast milk or formula can be altered in order to require less effort by the infant and decrease caloric output, thereby increasing the calories ingested to facilitate weight gain and growth. This adaptation may not be necessary when the cleft does not include the palate but can be implemented fairly easily when the baby appears to have difficulty obtaining adequate nutritional intake. Before and after any surgical intervention, the goal remains to continue to supply the infant with sufficient caloric intake to heal and to continue to grow. Although some surgeons may demand modifications in how the baby is fed postoperatively, many advocate cautious reinstitution of normal feeding practices. Early referral for dental care should be encouraged in children born with clefts because these children (even the very young) demonstrate higher dental needs. Education provided to parents regarding causes of and methods to reduce dental disease could help decrease its incidence and help these children require less invasive and difficult rehabilitation therapy.

Breast Feeding↗

PubMed1999

Assessment of long-chain polyunsaturated fatty acid nutritional supplementation on infant neurobehavioral development and visual acuity.

The aims of this paper are (i) to consider how best to examine effects of long-chain polyunsaturated fatty acid nutritional supplementation or deficiency on infant neurobehavioral development, after controlling for other factors that might influence outcome, including maternal demographic, intellectual, and personality characteristics, and (ii) to present new findings on the relation between visual acuity and processing speed and the effects of prenatal alcohol exposure and visual acuity on infant information processing. The following topics are also addressed: (i) breastfeeding and intelligence, (ii) criteria for the selection and control of potential confounding variables, and (iii) new infant information processing measures.

Ethanol↗

PubMed2005

Emotional regulation and its impact on development in extremely low birth weight infants.

The purposes of this study were to compare the Bayley Scales of Infant Development (BSID-II) scores at 8 and 18-22 months adjusted age of a cohort of 47 extremely low birth weight infants and to determine whether there was an association between changes in test scores and infant behavior as measured by the Behavioral Rating Scale of the BSID-II at 18-22 months adjusted age. Psychomotor Developmental Index scores did not differ between the two testing points (p = .17), whereas the Mental Developmental Index (MDI) scores dropped significantly (p = .006). Emotional regulation and low household income were both significantly associated with changes in MDI scores (p = .001 and p = .002, respectively). After adjusting for household income, the association between emotional regulation and changes in MDI scores remained significant (p = .02). Results suggest that infant behavioral characteristics, as well as family socioeconomic status, can adversely affect developmental outcome at 18-22 months adjusted age.

Adaptation, Psychological↗

PubMed1985

Studies on the development of infant foods from plant protein sources. Part I. Effect of germination of chickpea (Cicer arietinum) on the nutritive value and digestibility of proteins.

For the purpose of developing an infant food of improved dispersibility characteristics and high nutritive quality, different treatments and technologies were applied to chickpea (Cicer arietinum). Samples were germinated for two and four days at room temperature (25 - 27 degrees C). One portion of each germinated chickpea sample was boiled for 40 min and the other portion was autoclaved at 15 psi for 15 min. These processed samples were then compared with the corresponding value of raw germinated and ungerminated samples as well as with the ungerminated processed ones for the following characteristics: chemical composition, contents of antiphysiological factors, solubility of proteins, lysine availability, net protein ratio (NPR), and digestibility of proteins. Germination caused an increase in the protein content of the seeds. No appreciable changes were observed in the trypsin inhibitor and tannin contents during germination. Availability of lysine was found slightly lower in the germinated seeds. The solubility of the nitrogenous constituents was markedly increased during germination. Along with processing, germination had no beneficial effect in improving protein quality, although digestibility of the proteins was increased. Boiling was more advantageous in the case of germinated seeds than autoclaving, whereas the reverse was true in the case of ungerminated seeds.

Animals↗

PubMed1998

Effects of sleep position on infant motor development.

BACKGROUND: As a result of the American Academy of Pediatrics' recommendation that healthy infants be placed on their side or back for sleep, the percentage of infants sleeping prone has decreased dramatically. With the increase in supine sleeping, pediatricians have questioned if there are differences in the rate of acquisition of early motor milestones between prone and supine sleeping infants. METHODS: To examine this question, we performed a prospective, practice-based study of healthy term infants. Infants were recruited before the age of 2 months. Parents were asked to record infant sleep position and awake time spent prone until 6 months of age. A developmental log was used to track milestones from birth until the infant was walking. Age of acquisition of eight motor milestones was determined, and the mean ages of milestone attainment of prone and supine sleepers were compared. RESULTS: Three hundred fifty-one infants completed the study. Prone sleepers acquired motor milestones at an earlier age than supine sleepers. There was a significant difference in the age of attainment of rolling prone to supine, tripod sitting, creeping, crawling, and pulling to stand. There was no significant difference in age when infants walked. CONCLUSIONS: The pattern of early motor development is affected by sleep position. Prone sleepers attain several motor milestones earlier than supine sleepers. However, all infants achieved all milestones within the accepted normal age range. Pediatricians can use this information to reassure parents. This difference in milestone attainment is not a reason to abandon the American Academy of Pediatrics' sleep position recommendations.

Child Development↗

PubMed2001

Treadmill training of infants with Down syndrome: evidence-based developmental outcomes.

OBJECTIVE: On average, infants with Down syndrome (DS) learn to walk about 1 year later than nondisabled (ND) infants. The purpose of this study was to determine if practice stepping on a motorized treadmill could help reduce the delay in walking onset normally experienced by these infants. METHODS: Thirty families of infants with DS were randomly assigned to the intervention or control group. All infants were karyotyped trisomy 21 and began participation in the study when they could sit alone for 30 seconds (Bayley Scales of Infant Development, Second Edition 1993, item 34). Infants received traditional physical therapy at least every other week. In addition, intervention infants received practice stepping on a small, motorized treadmill, 5 days per week, for 8 minutes a day, in their own homes. Parents were trained to support their infants on these specially engineered miniature treadmills. Every 2 weeks research staff went into the homes and tested infants' overall motor progress by administering the Bayley Scales of Infant Development, Second Edition, monitored growth status via a battery of 11 anthropometric measures, and checked parents' compliance with physical therapy and treadmill intervention. The primary measures of the intervention's effectiveness were comparisons between the groups on the length of time elapsed between sitting for 30 seconds (entry into the study) and 1) raising self to stand; 2) walking with help; and 3) walking independently. RESULTS: The experimental group learned to walk with help and to walk independently significantly faster (73.8 days and 101 days, respectively) than the control group, both of which also produced large effect size statistics for the group differences. The groups were not statistically different for rate of learning to raise self to stand but there was a moderate effect size statistic suggesting that the groups were meaningfully different in favor of the experimental group. CONCLUSIONS: These results provide evidence that, with training and support, parents can use these treadmills in their homes to help their infants with DS learn to walk earlier than they normally would. Current research is aimed at 1) improving the protocol to maximize outcome; 2) determining the impact of treadmill practice on walking gait patterns; 3) testing the application to other populations with a history of delays in walking; and 4) determining the long-term benefits that may accrue from this form of activity. motor development, Down syndrome, early intervention, walking.

Age Factors↗

PubMed1996

Structural and neurobehavioral delay in postnatal brain development of preterm infants.

Postnatal brain development of healthy prematurely born infants was assessed to study possible influence of premature birth and early extrauterine environment on structural, biochemical, and functional brain development. Myelination and differentiation of gray and white matter were studied by in vivo magnetic resonance (MR) imaging (MRI), changes in cerebral metabolism by 1HMR spectroscopy (MRS), and changes in early human neurobehavior by the assessment of preterm infant's behavior (APIB). The stage of intrauterine and extrauterine brain development in prematurely born infants at term was compared with the stage of mainly intrauterine brain development in a group of full-term infants. Eighteen preterm infants unremarkable with respect to neurologic and medical status were studied at approximately 2 wk of postnatal age [gestational age (GA) 1: 32.5 +/- 1.2 wk] and again at term (GA 2: 40.0 +/- 1.1 wk). For comparison a group of 13 full-term born infants (GA T: 40.6 +/- 2.1 wk) were studied by MR and six by APIB. When GA 2 to GA 1 was compared, significant maturational changes were found with MRI in gray and white matter and myelination, with 1H MRS in the concentration of N-acetylaspartate and with all scores of APIB. In preterm infants at term (GA 2) compared with full-term infants (GA T) significantly less gray and white matter differentiation and myelination was observed as well as significantly poorer performance in four neurobehavioral parameters (autonomic reactivity, motoric reactivity, state organization, attentional availability). We conclude that MRI and 1H MRS can be used to study postnatal brain development in preterm infants. Structural and biochemical maturation is accompanied by functional maturation as shown with the neurobehavior assessment. Preterm infants at term compared with full-term infants show a structural as well as a functional delay in brain development assessed at 40 wk of postconceptional age.

Age Factors↗