Neurobehavioral profile of healthy full-term newborn infants of adolescent mothers
Marina Carvalho de Moraes Barros, MD, PhD: Neonatologist of the Division of Neonatal Medicine of the Federal University of São Paulo (UNIFESP)
Ruth Guinsburg, MD, PhD: Full Professor of the Division of Neonatal Medicine of UNIFESP
Sandro Mitsuhiro, MD: Researcher, Research Unit on Alcohol and Drugs of UNIFESP
Elisa Chalem: Researcher, Research Unit on Alcohol and Drugs of UNIFESP.
Ronaldo Ramos Laranjeira, MD, PhD:
Pregnancy in adolescence is a national public health problem in Brazil. In 2004, 2 655,290 (21.6%) born-alive infants in Brazil were children of 10 to 19 year-old mothers.1 3 In contrast, pregnancy occurred in 0.4% of girls aged 15 to 19 years in Japan, 0.8% in 4 Norway, 3.3% in the United Kingdom, 4.1% in Canada, and 6.1% in the USA.2 Teen 5 pregnancy is linked to other hazards, such as use of psychoactive substances, exposure to 6 sexually transmissible diseases, violence, and psychopathologic disorders. Individually or 7 in association, these factors can give rise to neurobehavioral disturbances in newborns.
The Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS) is a 9 scale used to assess neurological integrity, behavioral function and the existence of stress 10 and abstinence signs in newborn infants. It was designed for the Maternal Lifestyle study 11 published in 2002 by Lester et al. in order to analyze how babies were affected by intra-12 uterine exposure to drugs.4 The NNNS can be used for newborn infants with different 13 gestational ages and varied biological risks (prematurity, restricted intra-uterine growth), 14 diseases (perinatal asphyxia) or social hazards (improper prenatal care, intense maternal 15 stress, low socioeconomic level).5 As for the normality standards in this scale, there is only 16 one published study of the neurobehavioral profile of 125 full-term healthy newborns, 30 17 hours old, whose mothers were 18 to 30 years old.5 18
Several factors can interfere with the neurobehavioral responses of newborn infants 19 in their early days of life. Maternal factors include socio-demographic characteristics, such 20 as mother’s age and ethnicity, type of anesthesia applied during delivery, and use of licit 21 and illicit drugs by the pregnant woman.4,6-14 The main factors relevant to newborns include 22 gender, nutritional condition, prematurity, hyperbilirubinemia, and perinatal asphyxia