Neurobehavioral profile of moderate to late preterm infants admitted in a tertiary care centre in South India

Background and objectives: Neonatal neurobehavioral organization is a multidimensional holistic phenomenon which involves synchronous working of autonomic, sensory and motor systems to influence the developmental maturation of neonates. Homeostasis of all these systems is well developed in term infants but preterm infants, due to their physiological instability and incomplete cortical development, are at higher risk of impaired neurobehavioral organisation. Neurobehavioral maturity of term infants has been documented in many studies but there is dearth of literature in preterm infants, especially moderate to late preterm (MLP) category (32 weeks - 36 weeks of gestation). Thus the present study was aimed to assess the neurobehavioral profile of MLP infants and to compare it with standard reference scores provided in the NAPI manual. Methods: A cross sectional study was planned in which sixty moderate to late preterm infants were included during their stay in neonatal intensive care unit (NICU). Neurobehavioral assessment of preterm infants (NAPI) scale was used to document the neurobehavioral profile of preterm infants. Descriptive statistics was used to describe the baseline maternal and infant's characteristics. One sample t test was used for comparing the study sample and standard values provided in NAPI Manual for parametric analysis. Wilcoxon signed rank test was used for comparing variable values between two groups which were not following normal distribution. Results: Scarf sign at 34 and 36 weeks of gestation, motor development and vigor and alertness and orientation components of NAPI showed statistically significant difference between our study sample and standard reference values taken from NAPI manual. However statistically insignificant difference was found in popliteal angle, irritability, cry quality and percent sleep ratings domains of NAPI. Conclusion: In the present study on the neurobehavioral profile of our population, we found significant variability in scores for motor development and vigor, alertness and orientation and scarf sign domains for our study sample as compared to western standards provided in the NAPI manual.