Nina P Nosavan1, Lynne M Smith2, Lynne M Dansereau3, Mary B Roberts4, Julie A Hofheimer5, Brian S Carter6, Jennifer B Helderman7, Elisabeth C McGowan8, Charles R Neal9, Steve Pastyrnak10, Sheri A Della Grotta3, T Michael O'Shea5, Barry M Lester3,8,11. 1. Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA. 2. Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA. smith@lundquist.org. 3. Brown Center for the Study of Children at Risk, Women and Infants Hospital, Providence, RI, USA. 4. Center for Primary Care and Prevention, Care New England Medical Group, Pawtucket, RI, USA. 5. Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA. 6. Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO, USA. 7. Department of Pediatrics, Wake Forest School of Medicine, Winston Salem, NC, USA. 8. Department of Pediatrics, Brown Alpert Medical School and Women and Infants Hospital, Providence, RI, USA. 9. Department of Pediatrics, University of Hawaii John A Burns School of Medicine, Honolulu, HI, USA. 10. Department of Pediatrics, Spectrum Health - Helen DeVos Hospital, Grand Rapids, MI, USA. 11. Department of Psychiatry and Human Behavior, Brown Alpert Medical School, Providence, RI, USA.
Abstract
OBJECTIVE: To examine the relationship between maternal pre-pregnancy body mass index (BMI) and neonatal neurobehavior in very premature infants. STUDY DESIGN: Multi-center prospective observational study of 664 very preterm infants with 227 born to obese mothers. The NICU Network Neurobehavioral Scale (NNNS) assessed neurobehavior at NICU discharge. RESULTS: Elevated BMI combined with infection increased the odds of having the most poorly regulated NNNS profile by 1.9 times per BMI SD. Infants born to mothers with elevated BMI in combination with: infection had poorer self-regulation, chorioamnionitis had increased asymmetrical reflexes, diabetes had poorer attention, and low SES required more handling. CONCLUSION: Maternal pre-pregnancy BMI alone did not affect short-term neonatal neurobehavior in infants born before 30 weeks gestation. Infants born to mothers with elevated pre-pregnancy weight in addition to infections, diabetes, or socioeconomic adversity demonstrated increased risk of having the most poorly regulated NNNS profile and deficits in multiple domains.
OBJECTIVE: To examine the relationship between maternal pre-pregnancy body mass index (BMI) and neonatal neurobehavior in very premature infants. STUDY DESIGN: Multi-center prospective observational study of 664 very preterm infants with 227 born to obese mothers. The NICU Network Neurobehavioral Scale (NNNS) assessed neurobehavior at NICU discharge. RESULTS: Elevated BMI combined with infection increased the odds of having the most poorly regulated NNNS profile by 1.9 times per BMI SD. Infants born to mothers with elevated BMI in combination with: infection had poorer self-regulation, chorioamnionitis had increased asymmetrical reflexes, diabetes had poorer attention, and low SES required more handling. CONCLUSION: Maternal pre-pregnancy BMI alone did not affect short-term neonatal neurobehavior in infants born before 30 weeks gestation. Infants born to mothers with elevated pre-pregnancy weight in addition to infections, diabetes, or socioeconomic adversity demonstrated increased risk of having the most poorly regulated NNNS profile and deficits in multiple domains.
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