Different Positioning Practices in Neonatal Intensive Care Unit and their Effects on Neuromotor Development of Preterm Neonates: A Systematic Review

Introduction: Advances in neonatal intensive care have markedly improved the survival of preterm infants. However, without appropriate interventions, many preterm infants face long-term disabilities. Preterm infants often adopt postures that differ from those they would typically develop in utero. Therapeutic positioning is among the earliest neurodevelopmental interventions implemented in the Neonatal Intensive Care Unit (NICU). The primary goals of positioning are to provide support, facilitate movement and optimise neurodevelopment. Aim: To examine various positioning practices and their effects on neuromotor development in preterm infants admitted to the NICU. Materials and Methods: A literature search of PubMed, MEDLINE, CINAHL, DARE, ScienceDirect and Embase was conducted covering from January 2000 to June 2024, focusing on studies that examined different positioning techniques and their effects on posture and neuromotor development. Articles were screened against predefined inclusion and exclusion criteria. Eligible studies were identified and the methodological quality of the included studies was assessed. A qualitative synthesis of the findings was performed. Results: Eleven studies were included in this review. The included studies employed various postural strategies, such as different types of nests, mattresses and postural support devices (rolls or diapers) and assessed their effects on posture and neuromotor development. Conclusion: Positioning strategies for preterm infants are diverse. By adopting specific positions or using particular equipment, NICU care can address some of the unique needs of preterm infants during their stay. Positioning in certain positions may be associated with pain relief, improved flexion posture, enhanced neuromotor development and shorter lengths of hospital stay