Prenatal Programming of Infant Neurobehaviour in a Healthy Population

Paediatr Perinat Epidemiol. 2016 Jul;30(4):367-75. doi: 10.1111/ppe.12294. Epub 2016 Mar 23.


Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: developmental origins of health and disease; infant neurobehavior; prenatal programming; recursively partitioned mixture model.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Algorithms
  • Apgar Score
  • Birth Weight
  • Cognition / physiology*
  • Female
  • Fetal Distress
  • Gestational Age
  • Health*
  • Humans
  • Infant Behavior / physiology*
  • Infant, Newborn
  • Labor, Obstetric
  • Male
  • Maternal Age
  • Neurologic Examination*
  • Pregnancy
  • Prenatal Exposure Delayed Effects*
  • Rhode Island
  • Term Birth / physiology*
  • Weight Gain