In honor of World Prematurity Day...
In honor of World Prematurity Day, and #sciencefriday, I want to teach about a special part of our population that does not get much recognition: the Late Pre-term Infant.
Late Pre-Term Infants
Did you know that the average pre-term births in the United States is 450,000 per year? Of those, 75% are considered Late Pre-Term.1
A Late Pre-Term infant or “LPT” is defined as children born between 34 0/7 weeks and 36 6/7 weeks gestational age.1,2 Late pre-term infants are a highly at risk population for:
poor active movement
insufficient and slow brain growth and development3-7
The differences in LPT development compared to full-term peers:
1. Smaller Brain Size7
Decreased Cerebellar size (coordination center of the brain)
Decreased brainstem development (control center of functions such as breathing, swallowing, heart rate, blood pressure, ect)
Internal and external changes in the baby’s environment, stimulation, pain, and the inability to self regulate
Increases in Cortisol hormone: This hormone is released in presence of stress
How does high Cortisol levels effect the developing brain?
- Contributes to functional limitations in learning and memory due to hippocampus damage (part of the brainstem)
- Alters gene expression patterns which correlates with: changes in stress regulation, decreases in nerve conduction speeds, increases in the link for physical and mental disorders
3. Movement Pattern Differences6
I learned in a conference that if you have a camera and took one picture per second of a full-term infant for 60 seconds, all 60 pictures would be different. These full-term babies move in a variety of patterns and rarely repeat the same movements. On the other hand, LPT infants demonstrate “non-variable” movement patterns that may be slow and repetitive which stifles their neurological and musculoskeletal growth
Why do we care?
Currently, there is strong scientific evidence supporting pediatric physical therapy with preterm infants to improve motor skills and brain development.8,9 It is important for the community to be aware of the fragility of the Late Pre-Term population as well as possible implications for therapy interventions focused on developmental goals including nervous system stability, posture and movement, state regulation, and active engagement with caregivers10.