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.