Roberta G. Pineda, Lauren C. Reynolds, Kristin Seefeldt, Claudia L. Hilton, Cynthia E. Rogers, Terrie E. Inder; Head Lag in Infancy: What Is It Telling Us?. Am J Occup Ther 2015;70(1):7001220010. https://doi.org/10.5014/ajot.2016.017558
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© 2020 American Occupational Therapy Association
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.
More head lag was observed in infants with longer length of NICU stay, more days of endotracheal intubation, and sepsis.
The presence of head lag was related to cerebral injury and neurobehavioral alterations at term-equivalent age.
In this cohort of preterm infants, with many comorbidities, no associations between head lag and neurodevelopmental outcome at age 2 yr were found.
The presence of head lag decreases with advancing postmenstrual age.
Head lag was related to medical complications.
Head lag in the neonatal period was related to cerebral injury.
Head lag was related to early neurobehavior but not to neurodevelopmental outcome at 2 yr.
Head lag can provide the clinician with clinical information that can support the use of early therapeutic interventions aimed at optimizing outcomes.
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