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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

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Psychosocial and medical adversity associated with neonatal neurobehavior in infants born before 30 weeks gestation

Julie A Hofheimer1, Lynne M Smith2, Elisabeth C McGowan3

  • 1Department of Pediatrics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA. julie_hofheimer@med.unc.edu.

Pediatric Research
|October 11, 2019
PubMed

Insights

Maternal prenatal anxiety and depression are linked to poorer infant neurobehavior at neonatal intensive care unit (NICU) discharge. Identifying these risks early can help infants born prematurely receive timely interventions.

Area of Science:

  • Neonatal neurobehavioral research
  • Perinatal mental health
  • Developmental pediatrics

Background:

  • Psychosocial adversity significantly increases medical risks and poor outcomes for infants born before 30 weeks gestation.
  • Early identification of intervention needs in preterm infants can be achieved through neonatal neurobehavioral assessments and maternal psychological evaluations.
  • This study investigated the association between maternal prenatal factors and neonatal neurobehavioral outcomes.

Purpose of the Study:

  • To determine if maternal prenatal anxiety, depression, and adverse socioenvironmental conditions are associated with suboptimal neonatal neurobehavior at NICU discharge.
  • To identify specific maternal risk factors impacting infant neurobehavioral development.
  • To inform early intervention strategies for high-risk preterm infants.

Main Methods:

  • A cohort of 665 infants from 9 university NICUs was studied.
  • Standardized maternal interviews and medical record reviews were used to collect data on socioenvironmental, maternal, and neonatal medical factors.
  • Neonatal neurobehavior was assessed using the NICU Network Neurobehavioral Scale (NNNS) at NICU discharge.

Main Results:

  • Maternal prenatal anxiety was associated with decreased infant attention.
  • Prenatal maternal depression correlated with increased infant lethargy.
  • Maternal medical complications predicted suboptimal infant reflexes, while socioenvironmental risk predicted lower self-regulation and movement quality.
  • More severe neonatal medical complications were linked to lower attention, increased lethargy, and suboptimal reflexes in infants.

Conclusions:

  • Adverse prenatal maternal medical and psychosocial conditions, along with neonatal complications, are associated with neurobehavioral risks in infants.
  • Early identification of infants at elevated neurobehavioral risk can be facilitated by considering combined maternal and neonatal factors.
  • This research supports the integration of maternal health assessments into neonatal care for preterm infants.
Abstract

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