Document Detail

Earliest appropriate time for administering neurobehavioral assessment in newborn infants.
MedLine Citation:
PMID:  21172999     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess the effect of examination time on newborn neurobehavioral examinations administered within 48 hours of delivery and to identify the earliest appropriate time for performing the assessment.
METHODS: We analyzed data from neurobehavioral examinations on 324 newborns using the NICU Network Neurobehavioral Scale (NNNS). Trends over examination time and cumulative percentage within published normal ranges were analyzed to identify the earliest appropriate time for administering the examination. Ordinal logistic regression and multivariate regression were used for testing and defining the earliest appropriate time for administering the examination without being influenced by acute effects of labor and delivery while controlling for several potential confounding factors.
RESULTS: The arousal, excitability, lethargy, quality-of-movement, hypotonicity, and nonoptimal-reflexes scales were sensitive to timing of the examination. Results of ordinal logistic regression showed that 20 hours after delivery seemed to be the earliest appropriate time for administering newborn NNNS examinations. The proportion of NNNS scores within the normal range increased with time significantly when the examination was made less than 20 hours after delivery (n = 148) (odds ratio: 1.12 [95% confidence interval: 1.02-1.23]), but there was no longer significant association with time of examination after 20 hours (n = 176) (odds ratio: 1.04 [95% confidence interval: 0.99-1.09]). This result was confirmed by multivariate regression.
CONCLUSIONS: We recommend 20 hours after delivery as the earliest appropriate time for administering newborn NNNS examinations to obtain results reflecting outcomes that are a representative assessment of newborn neurobehavior and not contaminated by acute effects of labor and delivery.
Yingying Xu; Kimberly Yolton; Jane Khoury
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-12-20
Journal Detail:
Title:  Pediatrics     Volume:  127     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-03     Completed Date:  2011-01-31     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e69-75     Citation Subset:  AIM; IM    
General and Community Pediatrics Research, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, ML 7035, Cincinnati, OH 45229-3039, USA.
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MeSH Terms
Diagnostic Techniques, Neurological*
Infant Behavior*
Infant, Newborn
Neonatal Screening / standards*
Prospective Studies
Time Factors
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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