Alterations in Neurobehavior at Term Reflect Differing Perinatal Exposures in Very Preterm Infants

Brown, Nisha C.; Doyle, Lex W.; Bear, Merilyn; Inder, Terrie E.

doi:10.1542/peds.2006-0880

Cited by 89 publications

(77 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…They required more handling, were more excitable and had more nonoptimal and asymmetric reflexes. 17 Although our findings agree that preterm infants required more handling and scored less in hypotonicity, comparison to term norms in other domains (quality of movement, excitability, lethargy, asymmetry, stress abstinence and hypertonicity) revealed different relationships. One of the major differences between our study and the previous report is that we used the published norms while they had their own controls for comparison.…”

Section: Discussioncontrasting

confidence: 61%

“…Factors that positively affected their scores included female sex, maternal antenatal steroids and receiving any amount of breast milk on discharge. 17 In the same population, the NNNS abnormalities were weakly associated with magnetic resonance imaging abnormalities. Of the summary scores, only nonoptimal reflexes showed association with individual magnetic resonance imaging changes, namely white matter signal abnormalities and gray matter gyral maturation.…”

Section: Discussionmentioning

confidence: 92%

“…15 In another report, the NNNS was used as part of a developmental model of neurobehavioral dysregulation that could relate prenatal substance exposure to behavioral problems at age 7 years. 16 The use of NNNS in premature infants was explored in two main cohortsFan Australian cohort described by Brown et al 17 and the preterm subgroup of the MLS study. Brown et al reported their experience with a cohort of 168 premature infants (<30 weeks GA or <1250 g) examined at term-equivalent age.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Neurobehavioral assessment as a predictor of neurodevelopmental outcome in preterm infants

et al. 2011

View full text Add to dashboard Cite

Objective: Preterm infants are at risk for neurodevelopmental impairment. The Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS) is a standardized assessment for the neurobehavioral integrity of the newborn. The use of NNNS as a prognostic tool is still emerging. We hypothesized that the NNNS examination performed at term equivalent can detect neurobehavioral alterations in very low birth weight infants and can help in predicting their neurodevelopmental outcome at 18 months corrected age (CA).Study Design: This is a prospective study that included preterm infants with birth weight <1500 g and gestational age p34 weeks. They were evaluated with NNNS at term-equivalent and 12 summary scores were assigned. Infants who had 2 or more NNNS summary scores that were 2 s.d. beyond the mean of the study group were categorized as having abnormal NNNS. Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI) of Bayley Scales of Infant Development (BSID-II) were determined at 18 months CA. Multiple linear regression models were used to examine the predictivity of the NNNS summary scores for both MDI and PDI.Result: A total of 41 infants were evaluated at term and at 18 months CA. The average MDI was 78±15 and the average PDI was 80±14. Significant neurodevelopmental delay was observed in 50% and 31% of infants with abnormal and normal NNNS, respectively. Using multiple linear regression, NNNS was predictive for both MDI (P ¼ 0.011, adjusted R 2 ¼ 0.295) and PDI (P ¼ 0.002, adjusted R 2 ¼ 0.441). Lower MDI was associated with less regulation and more nonoptimal reflexes, whereas lower PDI was associated with less regulation, more nonoptimal reflexes, hypertonicity and handling.Conclusion: NNNS at term-equivalent age can detect neurobehavioral alterations in very low birth weight infants. Individual summary scores showed significant correlation with both the MDI and PDI at 18 months CA.

show abstract

Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Neurobehavioral assessment as a predictor of neurodevelopmental outcome in preterm infants

et al. 2011

View full text Add to dashboard Cite

show abstract

“…3 Ademais, a presença de comorbidades comuns na prematuridade (como hipóxia e displasia broncopulmonar) e o uso de alguns métodos assistenciais por períodos prolongados, tais como oxigenoterapia e ventilação mecânica invasiva, podem favorecer lesões neurológicas, provocando alterações transitórias ou duradouras, as quais podem variar desde um discreto atraso na aquisição das etapas motoras até o desenvolvimento de paralisia cerebral. 1,[4][5][6] Para muitos recém-nascidos prematuros, a permanência em Unidade de Terapia Intensiva (UTI) é essencial à manutenção da vida. Porém, no ambiente da unidade neonatal, a exposição constante à estimulação excessiva (ruídos, luminosidade, procedimentos dolorosos, entre outros) em crianças neurofisiologicamente imaturas pode desencadear alterações motoras e hemodinâmicas.…”

Section: Introductionunclassified

Fatores associados ao atraso do desenvolvimento motor de crianças prematuras internadas em unidade de neonatologia

Araújo

Eickmann

Coutinho

2013

Rev. Bras. Saude Mater. Infant.

View full text Add to dashboard Cite

show abstract

“…14,25 In this study, using a scale validated for neu- neurobehavioral changes in extreme preterm infants using the NNNS and reported that female babies exhibited better performance than males for "quality of movement". 29 It is known that higher levels of stress hormones are found in male newborn infants when they are subjected to stressful procedures. 30 It is possible that intrauterine growth restriction causes different cortical growth and organization changes during intrauterine life for male and female fetuses, depending on the predominant hormonal influence, which would explain the neurobehavioral differences observed in male and female SGA newborn infants during their first days of life.…”

Section: 2mentioning

confidence: 99%

Neurocomportamento de recém-nascidos a termo, pequenos para a idade gestacional, filhos de mães adolescentes

Barros¹,

Guinsburg²,

Mitsuhiro³

et al. 2008

J. Pediatr. (Rio J.)

View full text Add to dashboard Cite

Objective: To compare the neurobehavior of small (SGA) and adequate (AGA) for gestational age full-term neonates born to adolescent mothers. Methods:This prospective cross-sectional study included full-term newborn infants aged 24-72 hours, free from central nervous system malformations and born to adolescent mothers at a single center in Brazil. Infants were assessed with the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS) for: habituation, attention, arousal, regulation, handling, quality of movement, excitability, lethargy, nonoptimal reflexes, asymmetry, hypertonia, hypotonia, and stress/abstinence signals. The chi-square test and analysis of variance were used to compare SGA and AGA infants. Multivariate regression was used to analyze factors associated with the score of each NNNS variable.Results: Of 3,685 infants born in the study hospital, 928 (25%) had adolescent mothers. Of these, 477 infants met the inclusion criteria: 419 (88%) were AGA and 58 (12%) were SGA. Univariate analysis did not show any differences between AGA and SGA neonates in terms of NNNS variables. Multivariate analysis showed that SGA neonates born by vaginal delivery had lower scores for quality of movements than those born by caesarean section. The SGA neonates born with local or without anesthesia had higher scores for excitability than those born with spinal anesthesia.Additionally, female SGA neonates had lower scores for stress/abstinence signals than males. Conclusion:SGA neonates born to adolescent mothers showed poorer quality of movements, more excitability and more signals of stress in association with sex of infant and variables related to delivery.

show abstract

Alterations in Neurobehavior at Term Reflect Differing Perinatal Exposures in Very Preterm Infants

Cited by 89 publications

References 41 publications

Neurobehavioral assessment as a predictor of neurodevelopmental outcome in preterm infants

Neurobehavioral assessment as a predictor of neurodevelopmental outcome in preterm infants

Fatores associados ao atraso do desenvolvimento motor de crianças prematuras internadas em unidade de neonatologia

Neurocomportamento de recém-nascidos a termo, pequenos para a idade gestacional, filhos de mães adolescentes

Contact Info

Product

Resources

About