Analysis Of Perinatal Factors Influencing Neonatal Behavioral Neurological Assessment

ObjectiveTo investigate the associated perinatal factors influencing neonatal behavioral neurological assessment(NBNA). MethodsThe present study was conducted between July 2014 and June 2015 in the Neonatal Ward of The First Affiliated Hospital of Zhengzhou University. Neonates admitted within 24 hours after birth were eligible. The relevant clinical data as follows were recorded:gender, gestational age(GA), birth weight(BW), delivery mode, polycyesis, small for gestational(SGA), maternal age, gravidity, assisted reproduction, pregnancy complication(hypertension, cardiac insufficiency, diabetes mellitus, thrombocytopenia, hypohepatia), placenta previa, premature rupture of membranes, neonatal asphyxia, meconium-stained amniotic fluid, respiratory distress syndrome(RDS), patent ductus arteriosus(PDA), intracranial hemorrhage(ICH), mechanical ventilation, neonatal hypoglycemia, neonatal hypocalcemia, neonatal hyperbilirubinmia, plasma NT-pro BNP level. NBNA was conducted after birth in term infants, while at term in preterm infants. Those infants with incomplete record of clinical and/or accessory examinations were excluded. Infants were divided into two groups: NBNA ?35 score and NBNA <35 score. The effects of associated perinatal factors on NBNA were evaluated. A multiple logistic regression analysis was performed to determine the influencing factors for NBNA.Results1) A total of 338 infants(214 males and 124 females, 213 preterm infants and 125 term infants) were included in the present study. The infants had a median(IQR) GA of 35.4(33.0, 38.0) weeks and a median(IQR) BW of 2400(1700, 3080) g. Among these infants, 241 cases had a NBNA ?35 score and 97 cases had a NBNA <35 score.2) The occurrence of maternal hypertension, maternal diabetes mellitus, GA, BW, neonatal asphyxia, SGA, polycyesis, meconium-stained amniotic fluid, RDS, ICH, NT-pro BNP?25000pg/ml, mechanical ventilation and PDA was higher in infants with NBNA <35 score than those with NBNA ?35 score, significantly.3) The multiple logistic regression analysis suggested that neonatal asphyxia, ICH, RDS, GA, patent ductus arteriosus, mechanical ventilation and NT-pro BNP level were significantly correlated with the NBNA(P<0.05, all), and the odds ratio(OR)was 3.410, 6.691, 3.567, 6.018, 3.546, 8.714 and 2.719, respectively. Conclusion1) Gestational age, birth weight, maternal hypertension, maternal diabetes mellitus, neonatal asphyxia, small for gestational, polycresis, meconium-stained amniotic fluid, respiratory distress syndrome, intracranial hemorrhage, patent ductus arteriosus, mechanical ventilation, NT-pro BNP?25000pg/ml are related to NBNA of neonates.2) Gestational age, neonatal asphyxia, respiratory distress syndrome, intracranial hemorrhage, patent ductus arteriosus, mechanical ventilation and NT-pro BNP?25000pg/ml are the independent risk factors for NBNA of neonates.