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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neurobehavior of late preterm infants of adolescent mothers
Marina C M Barros1, Sandro Mitsuhiro, Elisa Chalem
1Division of Neonatal Medicine, Department of Pediatrics, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
Insights
Late preterm infants born to adolescent mothers show less mature neurobehavioral performance compared to full-term infants. This suggests a need for closer monitoring and support for these vulnerable newborns.
Area of Science:
- Neonatal Development
- Developmental Pediatrics
- Neuroscience
Background:
- Late preterm infants face increased neonatal morbidity and later school-age challenges.
- Limited data exists on neonatal neurobehavioral performance in late preterm infants, impacting developmental understanding.
Purpose of the Study:
- To compare the neurobehavioral performance of healthy late preterm neonates with that of full-term neonates born to adolescent mothers.
Main Methods:
- A prospective, cross-sectional study involving healthy late preterm (34-36 weeks) and full-term (40 weeks) neonates aged 24-72 hours.
- Infants were assessed using the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS).
- Outcomes were analyzed using ANOVA, adjusting for various clinical and demographic factors.
Main Results:
- Late preterm neonates exhibited significantly lower scores in attention, arousal, regulation, and quality of movements compared to term neonates.
- Conversely, late preterm infants showed higher scores for non-optimal reflexes and hypotonicity.
- These differences were statistically significant even after adjusting for confounding variables.
Conclusions:
- Late preterm infants of adolescent mothers demonstrate more immature neurobehavioral performance within the first 72 hours of life.
- Findings indicate a need for targeted follow-up and early intervention strategies for this population.
- Neurobehavioral assessment in early infancy can identify potential developmental risks.
Background:
Late preterm infants have higher morbidity in the neonatal period and difficulties at school age. There are few data about neonatal neurobehavior performance that may interfere in their development.
Objectives:
To compare the neurobehavior of healthy late preterm and full-term neonates born to adolescent mothers.
Methods:
This prospective cross-sectional study included infants with a gestational age of 40(0/7)-40(6/7) weeks (full term) and 34(0/7)-36(6/7) weeks (late preterm) aged 24-72 h without exposure to alcohol, tobacco, drugs or infections and free of clinical problems during the first 3 days of life. Infants were assessed with the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS). Outcomes were analyzed by ANOVA.
Results:
From July 2001 to November 2002, 3,685 infants were born, 928 of adolescent mothers. After exclusion, 36 late preterm and 96 term infants were enrolled. Adjusted for anesthesia type, delivery mode, gender, age at NNNS examination, time between last feeding and examination, and examination duration, late preterm, compared to term neonates, presented lower scores for attention (p = 0.041), arousal (p = 0.011), regulation (p < 0.001), quality of movements (p < 0.001) and higher scores for non-optimal reflexes (p < 0.001) and hypotonicity (p = 0.029).
Conclusion:
Late preterm infants of adolescent mothers have a more immature neurobehavioral performance at 24-72 h of life in multiple areas compared to term neonates suggesting a need for careful follow-up.
