Heurobehavior of full-term small for gestational age newborn infants of adolescent mothers

Objective: To compare the neurobehavior of small (SGA) and adequate (AGA) for gestational age full-term neonates born to adolescent mothers. Methods: This prospective cross-sectional study included full-term newborn infants aged 24-72 hours, free from central nervous system malformations and born to adolescent mothers at a single centerin Brazil. Infants were assessed with the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS) for: habituation, attention, arousal, regulation, handling, quality of movement, excitability, lethargy, nonoptimal reflexes, asymmetry, hypertonia, hypotonia, and stress/abstinence signals. The chi-square test and analysis of variance were used to compare SGA and AGA infants. Multivariate regression was used to analyze factors associated with the score of each NNNS variable. Results: Of 3,685 infants born in the study hospital, 928 (25%) had adolescent mothers. Of these, 477 infants met the inclusion criteria: 419 (88%) were AGA and 58 (12%) were SGA. Univariate analysis did not show any differences between AGA and SGA neonates in terms of NNNS variables. Multivariate analysis showed that SGA neonates born by vaginal delivery had lower scores for quality of movements than those born by caesarean section. The SGA neonates born with local or without anesthesia had higher scores for excitability than those born with spinal anesthesia. Additionally, female SGA neonates had lower scores for stress/abstinence signals than males. Conclusion: SGA neonates born to adolescent mothers showed poorer quality of movements, more excitability and more signals of stress in association with sex of infant and variables related to delivery.