Ventilatory support exposure in the neonatal intensive care unit and head and body positioning at term-equivalent age in preterm infants: A retrospective cohort study.

BACKGROUND: Neonatal intensive care (NICU) is essential for the survival of preterm infants; however, exposure to interventions such as ventilatory support within the NICU may influence early motor organization and developmental trajectories. OBJECTIVE: To investigate whether ventilatory support during neonatal hospitalization is associated with head and body positioning in preterm infants at term-equivalent age. METHODS: This retrospective cohort study included 92 preterm infants. Spontaneous movements were recorded for up to 5 min between 37 and 40 weeks of corrected age and independently analyzed by two blinded researchers. Head and body positioning were evaluated using a study-specific instrument based on three items derived from the Motor Optimality Score. Each item was classified as typical or atypical. In addition, a gestalt assessment of preferred head position was performed. Binomial regression models were fitted to examine the association between ventilatory support and head and body positioning. Variables with p < 0.10 in bivariate analyses were included in the model. RESULTS: Only 15% (13) of preterm infants exhibited a central head position, while 62% (57) displayed a right-sided head preference. Infants who required ventilatory support had threefold higher odds of absent head movement and 89% lower odds of maintaining symmetrical body alignment compared with unexposed peers. CONCLUSION: Exposure to ventilatory support is associated with postural asymmetries and reduced head mobility at term-equivalent age. These findings highlight the importance of appropriate positioning practices and warrant attention from professionals involved in neonatal intensive care.