Neurobehavioral profile of healthy full-term newborn infants of adolescent mothers

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2008-05-01
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Barros, Marina Carvalho de Moraes [UNIFESP]
Guinsburg, Ruth [UNIFESP]
Mitsuhiro, Sandro [UNIFESP]
Chalem, Elisa [UNIFESP]
Laranjeira, Ronaldo Ramos [UNIFESP]
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Background: the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS) is used to assess neurological integrity, behavioral function and the existence of stress and abstinence signs in newborn infants.Aim: To determine the neurobehavioral. profile of healthy term neonates of adolescent mothers.Design: Cross-sectional study with prospective collection of data.Subjects: 419 healthy newborns without analgesic/sedative use at labor, intra-uterine drug exposure, multiple gestation, congenital malformations or infections. the NNNS was applied with 33 7 hours of life in a quiet and dark room, between feedings. Outcome measures: Mean, SD, and 5th, 10th, 25th, 50th, 75th, 90th and 95th percentiles for each of 13 NNNS variables were determined and compared according to maternal age (12-14 years vs. 15-17 years vs. 18-19 years) by ANOVA.Results: Mothers had 17 +/- 1.5 years, 50% white, 7.1 +/- 2.2 years of education, prenatal care in 96%, vaginal delivery in 73%, and local/regional anesthesia in 75%. Neonates had birth weight 3205 299 g, gestational age 39.4 +/- 1.1 weeks, 55% male, 1 min Apgar 8.2 +/- 1.3, and 5 min Apgar 9.6 +/- 0.6. NNNS scores (mean +/- SD): habituation: 6.86 +/- 1.49; attention: 5.73 +/- 1.32; arousal: 3.70 +/- 0.70; regulation: 6.06 +/- 0.74; orientation handling procedures: 0.36 +/- 0.26; quality of movements: 5.11 +/- 0.49; excitability: 2.48 +/- 1.68; lethargy: 4.04 +/- 1.82; non-optimal reflexes: 3.67 +/- 1.35; asymmetry: 0.71 +/- 0.94; hypertonicity: 0.18 +/- 0.39; hypotonicity: 0.13 +/- 037; and stress/abstinence signs: 0.07 +/- 0.05. Infants of younger adolescent mothers were less lethargic than infants of older ones.Conclusion: the description of the neurobehavioral profile of healthy term newborns of adolescent mothers is important to establish normal standards for this population. (C) 2007 Elsevier Ireland Ltd. All rights reserved.
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Early Human Development. Clare: Elsevier B.V., v. 84, n. 5, p. 281-287, 2008.