[Influence of the delivery on neonatal competence]

It is a widely held view that the NBAS (Brazelton, 1973) can index differences in the level of the neurobehavioural organization of both pathological and normal newborns. The present study employed the NBAS to determine whether the type of delivery, i.e. cesarean or spontaneous vaginal, can influence the level of neurobehavioural organization in the first days of life. To this aim, two groups of healthy newborns, as assessed through obstetrical anamnesis and the Apgar index, were compared at 4, 24, 72 hours of postnatal life. Ten newborns were born by cesarean section and 10 were born by spontaneous vaginal delivery. The results did not show any neurobehavioural differences for the five clusters of the NBAS: Response decrement, Orientation, Motor, Range and Regulation of states. This outcome fails to support the hypothesis that the level of neurobehavioural organization in the first hours of postnatal life depends on the type of delivery. It must be considered, however, that the null results could be attributed to the way the NBAS is administered according to Brazelton's criteria of "best performance" and "flexibility of the examiner". In essence, these criteria require the NBAS to be administered several times in succession, by varying the order of clusters and the order of items within a cluster, until the "best performance" is obtained. Therefore, a second experiment was conducted, in which the criticisms and suggestions put forward by Prechtl (1982) were taken into account. Two groups of 10 newborns each, selected as before, were tested.(ABSTRACT TRUNCATED AT 250 WORDS)