title: Prenatal Programming of Infant Neurobehaviour in a Healthy Population.
abstract: Identifying the prenatal origins of mental conditions is of increasing interest, yet most studies have focused on high-risk populations and cannot disentangle prenatal and postnatal programming effects. Thus, we examined whether profiles of neurobehaviour indicative of future risk could be identified in healthy 1-3-day-old infants, and examined associations with perinatal risk factors.
  
  
  
  Participants included 627 healthy mothers and term infants from a population-based US cohort. Neurobehaviour was assessed within 24-72 h after delivery with the NICU Network Neurobehavioural Scales (NNNS). A model-based clustering algorithm was used to derive neurobehavioural profiles from NNNS scores. Maternal health histories, pregnancy conditions and behaviours, labour/delivery factors, and infant attributes were examined in relation to the neurobehavioural profiles.
  
  
  
  Seven discrete neurobehavioural profiles were identified, including one average functioning profile, and two inversely patterned below and above average profiles. Higher pregnancy weight gain (OR 1.44, 95% CI 1.10, 1.88) and birthweight percentiles (OR 1.46, 95% CI 1.10, 1.95) were associated with greater odds of below average newborn neurobehaviour. Above average neurobehaviour was associated with experiencing longer gestations (OR 1.29, 95% CI 1.02, 1.64) and higher 5-min APGAR scores (OR 2.43, 95% CI 1.07, 5.52). Maternal pregnancy alcohol use (OR 0.54, 95% CI 0.33, 0.89), and fetal distress (OR 0.10, 95% CI 0.01, 0.72) were associated with lower likelihood of having average neurobehaviour.
  
  
  
  Distinct profiles of neurobehaviour can be derived in a healthy population of newborns, with different sets of perinatal factors predicting different patterns of neurobehaviour. These findings suggest a potential in utero origin for mental health risk.
authors.affiliation: Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Rensselaer, NY.
authors.forename: Allison A
authors.initials: AA
authors.lastname: Appleton
authors.affiliation: Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH.
authors.forename: Megan A
authors.initials: MA
authors.lastname: Murphy
authors.affiliation: Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS.
authors.forename: Devin C
authors.initials: DC
authors.lastname: Koestler
authors.affiliation: Department of Pharmacology and Toxicology, Geisel School of Medicine at Dartmouth, Hanover, NH.
authors.forename: Corina
authors.initials: C
authors.lastname: Lesseur
authors.affiliation: Department of Pharmacology and Toxicology, Geisel School of Medicine at Dartmouth, Hanover, NH.
authors.forename: Alison G
authors.initials: AG
authors.lastname: Paquette
authors.affiliation: Department of Pediatrics, Women and Infants Hospital, Providence, RI.
authors.forename: James F
authors.initials: JF
authors.lastname: Padbury
authors.affiliation: Department of Pediatrics, Women and Infants Hospital, Providence, RI.|Center for the Study of Children at Risk, Brown Alpert Medical School and Women and Infants Hospital, Providence, RI.
authors.forename: Barry M
authors.initials: BM
authors.lastname: Lester
authors.affiliation: Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH.|Department of Pharmacology and Toxicology, Geisel School of Medicine at Dartmouth, Hanover, NH.
authors.forename: Carmen J
authors.initials: CJ
authors.lastname: Marsit
mesh_terms: D000328:Adult; D000465:Algorithms; D001034:Apgar Score; D001724:Birth Weight; D003071:Cognition / Q000502:physiology*; D005260:Female; D005316:Fetal Distress; D005865:Gestational Age; D006262:Health; D006801:Humans; D018730:Infant Behavior / Q000502:physiology*; D007231:Infant, Newborn; D007743:Labor, Obstetric; D008297:Male; D008423:Maternal Age; D009460:Neurologic Examination; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012237:Rhode Island; D047929:Term Birth / Q000502:physiology*; D015430:Weight Gain
keywords: developmental origins of health and disease; infant neurobehavior; prenatal programming; recursively partitioned mixture model