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Associations between maternal pre-pregnancy body mass index and neonatal neurobehavior in infants born before 30 weeks gestation

Abstract

Objective

To examine the relationship between maternal pre-pregnancy body mass index (BMI) and neonatal neurobehavior in very premature infants.

Study design

Multi-center prospective observational study of 664 very preterm infants with 227 born to obese mothers. The NICU Network Neurobehavioral Scale (NNNS) assessed neurobehavior at NICU discharge.

Results

Elevated BMI combined with infection increased the odds of having the most poorly regulated NNNS profile by 1.9 times per BMI SD. Infants born to mothers with elevated BMI in combination with: infection had poorer self-regulation, chorioamnionitis had increased asymmetrical reflexes, diabetes had poorer attention, and low SES required more handling.

Conclusion

Maternal pre-pregnancy BMI alone did not affect short-term neonatal neurobehavior in infants born before 30 weeks gestation. Infants born to mothers with elevated pre-pregnancy weight in addition to infections, diabetes, or socioeconomic adversity demonstrated increased risk of having the most poorly regulated NNNS profile and deficits in multiple domains.

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Fig. 1: NICU Network Neurobehavioral Scale Risk Profiles.
Fig. 2: Flow diagram for indentification of study cohort.

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Funding

Funded by National Institutes of Health (NIH)/Eunice Kennedy Shriver. National Institute of Child Health and Human Development (NICHD) grant R01HD072267.

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NPN was responsible for the conceptualization, investigation, and resources of the paper as well as the drafting and editing of the paper. LMS was responsible for the conceptualization, data curation, investigation, and supervision of the paper along with the drafting and editing of the paper. LMD and MBR were responsible for the methodology, data curation, formal analysis, and resources of the paper as well as the drafting and editing of the paper. JAH was responsible for the conceptualization, methodology, investigation, supervision, funding acquisition, data curation, and resources of the paper along with the drafting and editing of the paper. BSC, JBH, ECM, CRN, and SP were responsible for the methodology, investigation, and resources of the paper along with the editing of the paper. SADG was responsible for the methodology, investigation, data curation, and resources of the paper along with the editing of the paper. MO’S and BML were responsible for the conceptualization, methodology, investigation, supervision, funding acquisition, data curation, and resources of the paper along with the drafting and editing of the paper.

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Correspondence to Lynne M. Smith.

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Nosavan, N.P., Smith, L.M., Dansereau, L.M. et al. Associations between maternal pre-pregnancy body mass index and neonatal neurobehavior in infants born before 30 weeks gestation. J Perinatol 42, 483–490 (2022). https://doi.org/10.1038/s41372-021-01308-y

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