Elisabeth C McGowan1, Julie A Hofheimer2, T Michael O'Shea2, Brian S Carter3, Jennifer Helderman4, Charles R Neal5, Steve Pastyrnak6, Lynne M Smith7, Antoine Soliman8, Lynne M Dansereau9, Sheri A Della Grotta9, Barry M Lester10. 1. Department of Pediatrics, Brown Alpert Medical School, Women and Infants Hospital, Providence, RI, United States. Electronic address: emcgowan@wihri.org. 2. Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, United States. 3. Department of Pediatrics-Neonatology, Children's Mercy Hospital, Kansas City, MO, United States. 4. Department of Pediatrics, Wake Forest School of Medicine, Winston Salem, NC, United States. 5. Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, HI, United States. 6. Department of Pediatrics, Spectrum Health-Helen DeVos Hospital, Grand Rapids, MI, United States. 7. Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, United States. 8. Department of Pediatrics, Miller Children's and Women's Hospital Long Beach, Long Beach, CA, United States. 9. Brown Center for the Study of Children at Risk, Brown Alpert Medical School, Women and Infants Hospital, Providence, RI, United States. 10. Department of Pediatrics, Brown Alpert Medical School, Women and Infants Hospital, Providence, RI, United States; Brown Center for the Study of Children at Risk, Brown Alpert Medical School, Women and Infants Hospital, Providence, RI, United States; Department of Psychiatry and Human Behavior, Brown Alpert Medical School, Providence, RI, United States.
Abstract
BACKGROUND: Among preterm infants, neurodevelopmental outcomes are influenced by both medical and sociodemographic factors. Less is known about the impact on these factors on neonatal neurobehavioral patterns. OBJECTIVE: To determine associations between demographic, psychosocial and medical risk factors and neonatal neurobehavior. METHODS: Multi-center observational study of infants born <30 weeks enrolled in the Neonatal Neurobehavior and Outcomes in Very Preterm Infants (NOVI) Study between April 2014-May 2016. Maternal medical, demographic, and psychological variables and infant medical variables were prospectively collected. Demographic, substance, psychological and medical risk indices were developed. Neurobehavioral assessment was performed using the NICU Network Neurobehavioral Scale (NNNS) at NICU discharge. RESULTS: 709 infants were enrolled in the NOVI study, and for 679 infants with neurobehavioral assessments, 6 NNNS behavioral profiles were calculated using latent profile analysis. Profile 6 infants (n = 47/679, 7%) were atypical, having poor attention, self-regulation and movement quality, hypertonia and increased stress signs. After adjustment for site, profile 6 infants had significantly smaller head circumferences at birth (β -0.87; -1.59, -0.14), and higher rates of late sepsis (OR 3.38; CI 1.66, 6.92) compared to Profiles 1-5 infants. There were no significant differences in other neonatal morbidities between the two groups. Profile 6 infants had a higher prenatal demographic risk score (1.46 vs 1.07;β 0.34; CI 0.06, 0.61) compared to Profiles 1-5 infants. CONCLUSION: NNNS behavioral profiles identify an atypical behavioral pattern that is associated with early influences of demographic and medical variables. Such behavioral patterns may be seen as early as NICU discharge.
BACKGROUND: Among preterm infants, neurodevelopmental outcomes are influenced by both medical and sociodemographic factors. Less is known about the impact on these factors on neonatal neurobehavioral patterns. OBJECTIVE: To determine associations between demographic, psychosocial and medical risk factors and neonatal neurobehavior. METHODS: Multi-center observational study of infants born <30 weeks enrolled in the Neonatal Neurobehavior and Outcomes in Very Preterm Infants (NOVI) Study between April 2014-May 2016. Maternal medical, demographic, and psychological variables and infant medical variables were prospectively collected. Demographic, substance, psychological and medical risk indices were developed. Neurobehavioral assessment was performed using the NICU Network Neurobehavioral Scale (NNNS) at NICU discharge. RESULTS: 709 infants were enrolled in the NOVI study, and for 679 infants with neurobehavioral assessments, 6 NNNS behavioral profiles were calculated using latent profile analysis. Profile 6 infants (n = 47/679, 7%) were atypical, having poor attention, self-regulation and movement quality, hypertonia and increased stress signs. After adjustment for site, profile 6 infants had significantly smaller head circumferences at birth (β -0.87; -1.59, -0.14), and higher rates of late sepsis (OR 3.38; CI 1.66, 6.92) compared to Profiles 1-5 infants. There were no significant differences in other neonatal morbidities between the two groups. Profile 6 infants had a higher prenatal demographic risk score (1.46 vs 1.07;β 0.34; CI 0.06, 0.61) compared to Profiles 1-5 infants. CONCLUSION: NNNS behavioral profiles identify an atypical behavioral pattern that is associated with early influences of demographic and medical variables. Such behavioral patterns may be seen as early as NICU discharge.
Authors: Elisabeth C McGowan; Julie A Hofheimer; T Michael O'Shea; Howard Kilbride; Brian S Carter; Jennifer Check; Jennifer Helderman; Charles R Neal; Steve Pastyrnak; Lynne M Smith; Marie Camerota; Lynne M Dansereau; Sheri A Della Grotta; Barry M Lester Journal: JAMA Netw Open Date: 2022-07-01
Authors: Jennifer Helderman; T Michael O'Shea; Lynne Dansereau; Jennifer Check; Julie A Hofheimer; Lynne M Smith; Elisabeth McGowan; Charles R Neal; Brian S Carter; Steven L Pastyrnak; Bradford Betz; Joseph Junewick; Heather L Borders; Sheri A DellaGrotta; Barry M Lester Journal: JAMA Netw Open Date: 2022-04-01
Authors: Nina P Nosavan; Lynne M Smith; Lynne M Dansereau; Mary B Roberts; Julie A Hofheimer; Brian S Carter; Jennifer B Helderman; Elisabeth C McGowan; Charles R Neal; Steve Pastyrnak; Sheri A Della Grotta; T Michael O'Shea; Barry M Lester Journal: J Perinatol Date: 2022-02-07 Impact factor: 3.225
Authors: T Michael O'Shea; Monica McGrath; Judy L Aschner; Barry Lester; Hudson P Santos; Carmen Marsit; Annemarie Stroustrup; Crisma Emmanuel; Mark Hudak; Elisabeth McGowan; Simran Patel; Rebecca C Fry Journal: Pediatr Res Date: 2022-08-10 Impact factor: 3.953
Authors: Marie Camerota; Stefan Graw; Todd M Everson; Elisabeth C McGowan; Julie A Hofheimer; T Michael O'Shea; Brian S Carter; Jennifer B Helderman; Jennifer Check; Charles R Neal; Steven L Pastyrnak; Lynne M Smith; Lynne M Dansereau; Sheri A DellaGrotta; Carmen J Marsit; Barry M Lester Journal: Clin Epigenetics Date: 2021-09-10 Impact factor: 6.551