The most frequently observed behaviors were irregular respirations, pink color, postured flexion of the extremities, immature light sleep, and drowsiness. Least frequently observed behaviors consisted of burps, bowel movement, grunting, smooth motor movements, cooing, and speech movement. Regression analysis illustrated that the pattern of behavior was significantly similar week to week.

A classification system of various forms of major newborn birth injuries is clearly lacking in the literature. Currently, no scales exist for distinguishing degrees, extent, or distinctions of major birth injuries. The purpose of this study was to use published and online literature to explore the timing, prediction, and outcomes of major newborn birth injuries. Potential antecedents and causes were used in depicting what were reported to be major birth injuries. The outcome of this literature search was the development of a classification table synthesizing the most frequently reported (n = 20) major newborn birth injuries. This classification was developed according to (1) types of tissue involved in the primary injury, (2) how and when the injury occurred, and (3) the relationship of the injury to birth outcomes. A classification scheme is critically needed as the first step to achieving preventive interventions and plans for long-term recovery from birth injuries. Because major birth trauma contributes to increased neonatal morbidity and mortality, its occurrence requires careful study and preventive efforts to better promote newborn health.

The purpose of this study was to demonstrate how the check sheet of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) can be quantified and used in research. Using the quantified NIDCAP measures, the hypothesis that Caucasian male infants are less behaviorally competent while in a neonatal intensive care unit (NICU) was explored. Participants included 42 very preterm NICU infants. Eighty-five NIDCAP behaviors were quantified into scores ranging from 0 to 1, indicating the percentage of time each behavior was observed. Multivariate analyses were used in grouping the 85 NIDCAP behaviors into three subsystems of functioning. The hypothesis that Caucasian male infants were less competent was not supported; neither were gender differences found. Contrary to this hypothesis, African American infants were identified as more vulnerable on several behaviors. NIDCAP assessments were easily quantified. Once the entire NIDCAP exam has been quantified, practice applications may involve automated development of individualized care plans.

An index of transient mechanical birth trauma (TMBT), consisting of the presence or absence of molding, cephalohematoma, subconjunctival hemorrhage, body bruising, facial bruising, petechiae, forceps marks, diminished arm movements, and sensitivity to sudden position changes, was measured on a convenience sample of 196 healthy newborns. Six dimensions of the Neonatal Behavioral Assessment Scale (NBAS) and other newborn measures also were assessed. Vaginally delivered newborns had more TMBT than those delivered by cesarean section and of newborns delivered vaginally, macrosomics had more TMBT than nonmacrosomics. TMBT positively correlated with range of state, individual reflex items of resistance to left and right arm movement, predominant state during the NBAS exam, and time to complete the NBAS exam. TMBT negatively correlated with newborn state instability and 1- and 5-minute Apgars. The results supported the measure's validity and are discussed in terms of implications for practice and further research to explore TMBT's usefulness.

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