Prenatal and perinatal factors associated with neonatal neurobehavioral profiles in the ECHO Program.
Journal
Pediatric research
ISSN: 1530-0447
Titre abrégé: Pediatr Res
Pays: United States
ID NLM: 0100714
Informations de publication
Date de publication:
08 2023
08 2023
Historique:
received:
06
10
2022
accepted:
06
02
2023
revised:
23
11
2022
medline:
31
7
2023
pubmed:
26
2
2023
entrez:
25
2
2023
Statut:
ppublish
Résumé
Single-cohort studies have identified distinct neurobehavioral profiles that are associated with prenatal and neonatal factors based on the NICU Network Neurobehavioral Scale (NNNS). We examined socioeconomic, medical, and substance use variables as predictors of NNNS profiles in a multi-cohort study of preterm and term-born infants with different perinatal exposures. We studied 1112 infants with a neonatal NNNS exam from the Environmental influences on Child Health Outcomes (ECHO) consortium. We used latent profile analysis to characterize infant neurobehavioral profiles and generalized estimating equations to determine predictors of NNNS profiles. Six distinct neonatal neurobehavioral profiles were identified, including two dysregulated profiles: a hypo-aroused profile (16%) characterized by lethargy, hypotonicity, and nonoptimal reflexes; and a hyper-aroused profile (6%) characterized by high arousal, excitability, and stress, with low regulation and poor movement quality. Infants in the hypo-aroused profile were more likely to be male, have younger mothers, and have mothers who were depressed prenatally. Infants in the hyper-aroused profile were more likely to be Hispanic/Latino and have mothers who were depressed or used tobacco prenatally. We identified two dysregulated neurobehavioral profiles with distinct perinatal antecedents. Further understanding of their etiology could inform targeted interventions to promote positive developmental outcomes. Prior research on predictors of neonatal neurobehavior have included single-cohort studies, which limits generalizability of findings. In a multi-cohort study of preterm and term-born infants, we found six distinct neonatal neurobehavioral profiles, with two profiles being identified as dysregulated. Hypo- and hyper-aroused neurobehavioral profiles had distinct perinatal antecedents. Understanding perinatal factors associated with dysregulated neurobehavior could help promote positive developmental outcomes.
Sections du résumé
BACKGROUND
Single-cohort studies have identified distinct neurobehavioral profiles that are associated with prenatal and neonatal factors based on the NICU Network Neurobehavioral Scale (NNNS). We examined socioeconomic, medical, and substance use variables as predictors of NNNS profiles in a multi-cohort study of preterm and term-born infants with different perinatal exposures.
METHODS
We studied 1112 infants with a neonatal NNNS exam from the Environmental influences on Child Health Outcomes (ECHO) consortium. We used latent profile analysis to characterize infant neurobehavioral profiles and generalized estimating equations to determine predictors of NNNS profiles.
RESULTS
Six distinct neonatal neurobehavioral profiles were identified, including two dysregulated profiles: a hypo-aroused profile (16%) characterized by lethargy, hypotonicity, and nonoptimal reflexes; and a hyper-aroused profile (6%) characterized by high arousal, excitability, and stress, with low regulation and poor movement quality. Infants in the hypo-aroused profile were more likely to be male, have younger mothers, and have mothers who were depressed prenatally. Infants in the hyper-aroused profile were more likely to be Hispanic/Latino and have mothers who were depressed or used tobacco prenatally.
CONCLUSIONS
We identified two dysregulated neurobehavioral profiles with distinct perinatal antecedents. Further understanding of their etiology could inform targeted interventions to promote positive developmental outcomes.
IMPACT
Prior research on predictors of neonatal neurobehavior have included single-cohort studies, which limits generalizability of findings. In a multi-cohort study of preterm and term-born infants, we found six distinct neonatal neurobehavioral profiles, with two profiles being identified as dysregulated. Hypo- and hyper-aroused neurobehavioral profiles had distinct perinatal antecedents. Understanding perinatal factors associated with dysregulated neurobehavior could help promote positive developmental outcomes.
Identifiants
pubmed: 36841884
doi: 10.1038/s41390-023-02540-2
pii: 10.1038/s41390-023-02540-2
pmc: PMC10440230
mid: NIHMS1874662
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
762-770Subventions
Organisme : NIH HHS
ID : U24 OD023382
Pays : United States
Organisme : NIMH NIH HHS
ID : K01 MH129510
Pays : United States
Organisme : NIH HHS
ID : UH3 OD023348
Pays : United States
Organisme : NIH HHS
ID : U24 OD023319
Pays : United States
Organisme : NIH HHS
ID : UH3 OD023347
Pays : United States
Organisme : NIH HHS
ID : U2C OD023375
Pays : United States
Organisme : NIH HHS
ID : UH3 OD023320
Pays : United States
Organisme : NIH HHS
ID : UH3 OD023249
Pays : United States
Organisme : NICHD NIH HHS
ID : R01 HD084515
Pays : United States
Organisme : NIH HHS
ID : UH3 OD023275
Pays : United States
Organisme : NIH HHS
ID : UH3 OD023318
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2023. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.
Références
Curr Opin Pediatr. 2018 Apr;30(2):260-262
pubmed: 29356702
Addiction. 2012 Nov;107 Suppl 1:63-73
pubmed: 23106928
J Pediatr. 2022 Apr;243:21-26
pubmed: 34971656
J Pediatr. 2010 Mar;156(3):366-71
pubmed: 19880137
Infant Behav Dev. 2011 Feb;34(1):26-34
pubmed: 21035873
Dev Psychobiol. 2017 Jul;59(5):574-582
pubmed: 28561904
Pediatrics. 2009 May;123(5):e842-8
pubmed: 19403478
Arch Dis Child Fetal Neonatal Ed. 2005 Jan;90(1):F73-4
pubmed: 15613582
Pediatrics. 2009 Nov;124(5):1355-62
pubmed: 19822596
JAMA Netw Open. 2022 Jul 1;5(7):e2222249
pubmed: 35849396
Med Epigenet. 2014 May;2(2):71-79
pubmed: 25089125
Pediatrics. 2021 Aug;148(2):
pubmed: 34301772
Pediatrics. 2002 Dec;110(6):1182-92
pubmed: 12456917
Women Birth. 2018 Feb;31(1):52-58
pubmed: 28711396
Pediatrics. 2010 Jan;125(1):e90-8
pubmed: 19969621
JAMA Netw Open. 2022 Apr 1;5(4):e226561
pubmed: 35394511
J Pediatr. 2022 Jul;246:71-79.e3
pubmed: 35430247
Acta Paediatr. 2015 May;104(5):e188-94
pubmed: 25620086
Paediatr Perinat Epidemiol. 2012 Jul;26(4):344-52
pubmed: 22686386
Paediatr Perinat Epidemiol. 2016 Jul;30(4):367-75
pubmed: 27004434
Pediatr Res. 2022 Nov;92(5):1262-1269
pubmed: 34131290
Demography. 2018 Dec;55(6):2229-2255
pubmed: 30387046
PLoS One. 2020 Oct 16;15(10):e0240905
pubmed: 33064777
J Obstet Gynaecol Can. 2011 Nov;33(11):1105-1115
pubmed: 22082784
Subst Use Misuse. 2010 Nov;45(13):2244-57
pubmed: 20482340
Matern Child Health J. 2013 Nov;17(9):1689-700
pubmed: 23135625
J Law Med Ethics. 2020 Sep;48(3):506-517
pubmed: 33021163
Early Hum Dev. 2020 Mar;142:104954
pubmed: 32007912
J Perinatol. 2015 Aug;35(8):580-4
pubmed: 25789817
J Perinatol. 2021 Oct;41(10):2449-2462
pubmed: 34012055
Environ Res. 2020 Apr;183:109204
pubmed: 32311904
Am J Obstet Gynecol. 2017 Mar;216(3):306.e1-306.e12
pubmed: 27865977
Pediatr Res. 2020 Mar;87(4):721-729
pubmed: 31600769
N Engl J Med. 2010 Dec 9;363(24):2320-31
pubmed: 21142534
Early Hum Dev. 2018 Feb;117:7-14
pubmed: 29223912
J Pediatr. 2012 Dec;161(6):1073-9
pubmed: 22727876
Dev Psychopathol. 2018 Aug;30(3):1087-1105
pubmed: 30068428
Pediatrics. 2003 Jun;111(6 Pt 1):1318-23
pubmed: 12777547
Pediatr Res. 2009 Dec;66(6):704-9
pubmed: 19690513
Pediatrics. 2004 Mar;113(3 Pt 2):634-40
pubmed: 14993523
J Pediatr. 2020 Apr;219:146-151.e1
pubmed: 31987653
Curr Opin Pediatr. 2018 Apr;30(2):269-275
pubmed: 29474274
Early Hum Dev. 2016 May;96:7-14
pubmed: 26964011
Pediatrics. 2013 Mar;131(3):e881-93
pubmed: 23420913
Curr Opin Pediatr. 2018 Apr;30(2):276-284
pubmed: 29406440
Pediatrics. 2004 Mar;113(3 Pt 2):641-67
pubmed: 14993524
Pediatr Res. 2022 Nov;92(5):1470-1478
pubmed: 35173301