Healthy newborns' neurobehavior: norms and relations to medical and demographic factors.
OBJECTIVE
To generate neurobehavioral norms for an unselected random sample of clinically healthy newborns by examining the newborns with use of the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS).


METHODS
We recruited 344 healthy mothers and newborns from a well-child nursery. The NNNS, a 128-item assessment of infant neurobehavior, was used to examine newborn performance. Associations between 11 NNNS summary scales and the stress/abstinence scale, as well as medical and demographic variables, were evaluated. Mean, SD, and 5th and 95th percentile values for the summary scores of the NNNS are presented.


RESULTS
NNNS scores from the 10th to the 90th percentile represent a range of normative performance. Performance on different neurobehavioral domains was related to marital status, ethnicity, prenatal, intrapartum and neonatal risk factors, complications during labor/delivery, cesarean delivery, gestational age, the age of the newborn at testing, and infant sex.


CONCLUSIONS
These data provide clinicians and researchers with normative data for evaluation of newborn neurobehavior. Even in a low-risk sample, medical and demographic factors below clinical cut-offs were related to newborn performance. Infants with scores outside the ranges for the 11 NNNS summary scores and the stress/abstinence scale may need further observation and, if necessary, early intervention.
Department of Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Nadine S
NS
Fink
Edward
E
Tronick
Karen
K
Olson
Barry
B
Lester
D000367:Age Factors; D000704:Analysis of Variance; D002585:Cesarean Section; D003710:Demography; D005260:Female; D005865:Gestational Age; D006801:Humans; D018730:Infant Behavior / Q000208:ethnology / Q000502:physiology / Q000523:psychology; D007231:Infant, Newborn; D008297:Male; D009483:Neuropsychological Tests; D011247:Pregnancy; D011248:Pregnancy Complications; D012016:Reference Values; D012044:Regression Analysis; D012737:Sex Factors; D012959:Socioeconomic Factors