TY - JOUR
T1 - Neonatal Intensive Care Unit Network Neurobehavioral Scale Profiles in Full-Term Infants
T2 - Associations with Maternal Adversity, Medical Risk, and Neonatal Outcomes
AU - Parikh, Amisha N.
AU - Triplett, Regina L.
AU - Wu, Tiffany J.
AU - Arora, Jyoti
AU - Lukas, Karen
AU - Smyser, Tara A.
AU - Miller, J. Philip
AU - Luby, Joan L.
AU - Rogers, Cynthia E.
AU - Barch, Deanna M.
AU - Warner, Barbara B.
AU - Smyser, Christopher D.
N1 - Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/7
Y1 - 2022/7
N2 - Objectives: To examine healthy, full-term neonatal behavior using the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS) in relation to measures of maternal adversity, maternal medical risk, and infant brain volumes. Study design: This was a prospective, longitudinal, observational cohort study of pregnant mothers followed from the first trimester and their healthy, full-term infants. Infants underwent an NNNS assessment and high-quality magnetic resonance imaging 2-5 weeks after birth. A latent profile analysis of NNNS scores categorized infants into neurobehavioral profiles. Univariate and multivariate analyses compared differences in maternal factors (social advantage, psychosocial stress, and medical risk) and neonatal characteristics between profiles. Results: The latent profile analysis of NNNS summary scales of 296 infants generated 3 profiles: regulated (46.6%), hypotonic (16.6%), and fussy (36.8%). Infants with a hypotonic profile were more likely to be male (χ2 = 8.601; P =.014). Fussy infants had smaller head circumferences (F = 3.871; P =.022) and smaller total brain (F = 3.522; P =.031) and cerebral white matter (F = 3.986; P =.020) volumes compared with infants with a hypotonic profile. There were no differences between profiles in prenatal maternal health, social advantage, or psychosocial stress. Conclusions: Three distinct neurobehavioral profiles were identified in healthy, full-term infants with hypotonic and fussy neurobehavioral features related to neonatal brain volumes and head circumference, but not prenatal exposure to socioeconomic or psychosocial adversity. Follow-up beyond the neonatal period will determine if identified profiles at birth are associated with subsequent clinical or developmental outcomes.
AB - Objectives: To examine healthy, full-term neonatal behavior using the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS) in relation to measures of maternal adversity, maternal medical risk, and infant brain volumes. Study design: This was a prospective, longitudinal, observational cohort study of pregnant mothers followed from the first trimester and their healthy, full-term infants. Infants underwent an NNNS assessment and high-quality magnetic resonance imaging 2-5 weeks after birth. A latent profile analysis of NNNS scores categorized infants into neurobehavioral profiles. Univariate and multivariate analyses compared differences in maternal factors (social advantage, psychosocial stress, and medical risk) and neonatal characteristics between profiles. Results: The latent profile analysis of NNNS summary scales of 296 infants generated 3 profiles: regulated (46.6%), hypotonic (16.6%), and fussy (36.8%). Infants with a hypotonic profile were more likely to be male (χ2 = 8.601; P =.014). Fussy infants had smaller head circumferences (F = 3.871; P =.022) and smaller total brain (F = 3.522; P =.031) and cerebral white matter (F = 3.986; P =.020) volumes compared with infants with a hypotonic profile. There were no differences between profiles in prenatal maternal health, social advantage, or psychosocial stress. Conclusions: Three distinct neurobehavioral profiles were identified in healthy, full-term infants with hypotonic and fussy neurobehavioral features related to neonatal brain volumes and head circumference, but not prenatal exposure to socioeconomic or psychosocial adversity. Follow-up beyond the neonatal period will determine if identified profiles at birth are associated with subsequent clinical or developmental outcomes.
KW - latent profile analysis
KW - neonatal brain volumes
KW - psychological stress
KW - socioeconomic status
UR - http://www.scopus.com/inward/record.url?scp=85130468205&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2022.04.016
DO - 10.1016/j.jpeds.2022.04.016
M3 - Article
C2 - 35430247
AN - SCOPUS:85130468205
SN - 0022-3476
VL - 246
SP - 71-79.e3
JO - Journal of Pediatrics
JF - Journal of Pediatrics
ER -