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The NICU became a second home for Jaimie Leonard after she gave birth prematurely to daughter Quinn at 29 weeks. “I saw the excellent care that staff provided to my daughter, and the nurses quickly became family,” she said.
Leonard observed something else during the long hours she spent at BWH over seven weeks—that staff are constantly striving to improve care through research. “Everyone at the Brigham is always trying to understand things and ask questions to make the care even better,” she said.
That’s why Leonard agreed to have Quinn participate in a new study about the auditory attention of preterm babies. “Any study that provides information about preterm babies is extremely important,” she said. “If we can help in any small way, I want to do that.”
This particular study, conducted by Emily Zimmerman, PhD, a postdoctoral fellow in the lab of Amir Lahav, ScD, PhD, focuses on how premature infants respond to various sounds, including whether they prefer their mother’s voice over another female’s voice. The study may have the long-term potential to determine whether there is an early biomarker for ADHD, which typically isn’t detected until school age.
Babies born prematurely (before 37 weeks gestation) may be at risk for developmental problems that could persist throughout their lives, including problems with auditory attention, or the child’s ability to concentrate on and listen to sounds for an extended period of time, especially in a distracted environment.
The goal is to enroll 30 premature babies in the study. Prior to the auditory attention test, Zimmerman records the baby’s mother saying brief sentences in an infant-directed fashion, or ‘motherese’. Throughout the test, the baby hears pre-recorded sounds, including the mother’s voice, another female’s voice and standard NICU sounds, followed by silence. “We do this repeatedly for several minutes,” said Zimmerman.
The baby’s responses to the sounds are recorded by a nano-video camera throughout the test. The test also uses unique advanced eye–tracking technology, which enables the researchers to study eye gaze fixation and location as well as pupil dilation in response to sounds coming from micro speakers installed in the infant’s crib.
“We’re many years away from finding out whether this screening can be used to predict ADHD outcomes,” said Zimmerman. “If that turns out to be the case, this early screen test could help point parents toward early interventions that target the attention delays we identify with our first-of-its-kind auditory attention screening tool.”
After the attention test in the NICU, Zimmerman will mail a follow-up questionnaire to the parents to learn more about the attention and behavioral skills of their child at two years of age.
“The advanced instrumentations for this study would not have been possible without the great help we have received from BWH, especially Maureen Nephew and Phil Levine from Biomedical Engineering and Robert Patterson from the Engineering Department,” said Lahav.
This study is funded by the Waterloo Foundation.
The Effect of Maternal Sounds on Preterm Newborns
The attention study uses equipment that was partially created for another study Lahav began in 2010. He published the results last month in The Journal of Maternal-Fetal and Neonatal Medicine, showing a link between the brain development of vulnerable newborns and exposure to maternal sounds.
“Our findings show that there may be a window of opportunity to improve the physiological health of babies born prematurely using auditory simulation,” he said.
The research linked exposure to an audio recording of the mother’s heartbeat and her voice to a lower incidence of cardio-respiratory events in preterm infants. These infants typically experience high rates of adverse heart and lung events, such as apnea, a pause in breathing that lasts longer than 20 seconds, and bradycardia, slowing of the heart rate below 80 beats per minute. Researchers found that cardio-respiratory events occurred at a much lower frequency when the infants were exposed to maternal sound stimulation versus routine hospital noise and sounds.
“The results also suggest that there is a period of time when the infant’s auditory development is most intact that this intervention of maternal sound stimulation could be most effective,” Lahav said. “However, further research is needed.”