Development of the forward parachute reaction and the age of walking in near term infants: a longitudinal observational study.
BACKGROUND
Near term infants are a main part of preterms. They are at higher risk for mortality and morbidity than term infants and could show a quite different development of tone and reflexes from them. The aim of the present study was to describe longitudinally, in a large sample of healthy near term infants, the development of the forward parachute reaction (FPR) and its correlation with the age of acquisition of independent walking.


METHODS
The assessment of FPR (as absent, incomplete or complete) was performed at 3, 6, 9, 12 months of corrected age in 484 infants, with a gestational age between 35.0 and 36.9 weeks. The age of acquisition of independent walking was monitored until its appearance. A correlation analysis was done between the age of walking and the acquisition of a complete or incomplete FPR, using the Spearman Rank correlation. The Mann-Withney U test was used to identify significant gestational age differences for the age of FPR appearance.


RESULTS
Most of infants had a two-step development pattern. In fact, they showed at first an incomplete and then a complete FPR, which was observed more frequently at 9 months. An incomplete FPR only, without a successive maturation to a complete FPR, was present in the 21% of the whole sample. Infants with a complete FPR walked at a median age of 13 months, whereas those with an incomplete FPR only walked at a median age of 14 months.


CONCLUSIONS
We identified two groups within our sample of near term infants. The first group showed a progressive maturation of FPR, whereas the second one was characterised by the inability to get a complete pattern, within the one year observation's period. Furthermore, we observed a trend toward a delayed acquisition of independent walking in the latter group of infants.
Romeo
Domenico M M
DM
Division of Child Neurology and Psychiatry, Department of Paediatrics, University of Catania, Catania, Italy. dmmromeo@hotmail.it
Cioni
Matteo
M
Scoto
Mariacristina
M
Palermo
Filippo
F
Pizzardi
Alessandra
A
Sorge
Anna
A
Romeo
Mario G
MG
D000058:Accidental Falls / Q000517:prevention & control*; D000367:Age Factors; D002657:Child Development / Q000502:physiology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D008124:Locomotion / Q000502:physiology; D008137:Longitudinal Studies; D008297:Male; D009460:Neurologic Examination / Q000379:methods; D011187:Posture / Q000502:physiology*; D012018:Reflex / Q000502:physiology*; D016138:Walking / Q000502:physiology*