TABLE 4.
Summary of results from the Brazelton Neonatal Behavioral Assessment Scale (BNBAS)
| Center for Health Assessment of Mothers and Children of Salinas (CHAMACOS) | Mt. Sinai Children's Environmental Health Cohort Study | |||
|---|---|---|---|---|
| Young et al., 2005 | Engel et al., 2007 | |||
| Exposure measurement | DEPs in maternal urine | DAPs in maternal urine | DEPs in maternal urine | DAPs in maternal urine |
| Exposure variable format | Continuous: (nmol/L – log10) | Continuous: (nmol/L – log10) | Continuous: (nmol/L – log10) | Continuous: (nmol/L – log10 |
| Sample size for analysis | Range: 175–381 (full sample) | Range: 144–253 | ||
| BNBAS (Assessment < 3 days after birth) β (95% CI) | BNBAS (within 5 days of delivery) β (95% CI) | |||
| Habituation | 0.47 (–0.05, 0.99) | 0.10 (–0.40, 0.60) | 0.17 (–0.23, 0.57) | 0.08 (–0.30, 0.46) |
| Orientation | –0.11 (–0.65, 0.43) | –0.02 (–0.53, 0.49) | –0.11 (–0.41, 0.20) | –0.03 (–0.34, 0.28) |
| Motor | 0.08 (–0.17, 0.33) | 0.04 (–0.20, 0.28) | 0.05 (–0.08, 0.17) | 0.05 (–0.08, 0.17) |
| Range of State | –0.21 (–0.54, 0.12) | 0.11 (–0.21, 0.43) | 0.04 (–0.12, 0.19) | 0.02 (–0.14, 0.17) |
| Regulation of State | –0.08 (–0.52, 0.37) | –0.07 (–0.50, 0.36) | –0.05 (–0.30, 0.21) | –0.03 (–0.28, 0.23) |
| Autonomic Stability | 0.31 (0.01, 0.61)* | –0.09 (–0.38, 0.20) | –0.15 (–0.38, 0.08) | –0.11 (–0.33, 0.12) |
| Number of Abnormal Reflexes | 0.08 (–0.16, 0.32) | –0.01 (0.24, 0.22) | RRa = 1.49 (1.12, 1.98)* | RRa = 1.32 (0.99, 1.77) |
| BNBAS (Assessment ≥ 3 days after birthb) β (95% CI) | ||||
| Habituation | 0.20 (–0.43, 0.83) | 0.06 (–0.54, 0.66) | NR | NR |
| Orientation | –0.33 (–0.73, 0.08) | –0.13 (–0.54, 0.27) | NR | NR |
| Motor | 0.17 (–0.05, 0.38) | –0.07 (–0.28, 0.15) | NR | NR |
| Range of State | 0.20 (–0.21, 0.62) | –0.02 (–0.44, 0.40) | NR | NR |
| Regulation of State | –0.24 (–0.72, 0.24) | –0.10 (–0.58, 0.37) | NR | NR |
| Autonomic Stability | –0.16 (–0.47, 0.14) | –0.19 (–0.49, 0.12) | NR | NR |
| Number of Abnormal Reflexes | 0.37 (0.09, 0.64)* | 0.53 (0.23, 0.82)* | NR | NR |
| BNBAS (full sampleb) β (95% CI) | ||||
| Habituation | 0.33 (–0.06, 0.72) | 0.03 (–0.34, 0.40) | – | – |
| Orientation | –0.32 (–0.66, 0.03) | –0.17 (–0.50, 0.17) | – | – |
| Motor | 0.10 (–0.06, 0.27) | –0.03 (–0.19, 0.14) | – | – |
| Range of State | –0.02 (–0.27, 0.24) | 0.09 (–0.16, 0.34) | – | – |
| Regulation of State | –0.15 (–0.47, 0.17) | –0.07 (–0.39, 0.24) | – | – |
| Autonomic Stability | 0.06 (–0.15, 0.27) | –0.16 (–0.36, 0.05) | – | – |
| Number of Abnormal Reflexes | 0.22 (0.04, 0.40)* | 0.23 (0.05, 0.41)* | – | – |
| Covariates** | ||||
| Habituation | Age at BNBAS, smoking, alcohol, method of delivery, minutes fed since BNBAS, BNBAS interviewer. | Drug use during pregnancy, examiner, PON1 enzyme tertiles, urinary creatinine. | ||
| Orientation | Age at BNBAS, BNBAS interviewer, number of prenatal care visits. | Pre-pregnancy BMI, examiner, neonatal jaundice, PON1 enzyme tertiles, urinary creatinine. | ||
| Motor | Age at BNBAS, poverty level, gestational age at initiation of prenatal care, BNBAS interviewer. | Age at BNBAS, caffeine consumption during pregnancy, drug use during pregnancy, examiner, PON1 enzyme tertiles, urinary creatinine. | ||
| Range of State | Age at BNBAS, number of prenatal care visits, gestational age at initiation of prenatal care, alcohol, BNBAS interviewer. | Age at BNBAS, examiner, PON1 enzyme tertiles, urinary creatinine. | ||
| Regulation of State | Age at BNBAS, pre-pregnancy BMI, infant sex, parity, caffeine use, BNBAS interviewer. | Maternal education, examiner, PON1 enzyme tertiles, urinary creatinine. | ||
| Autonomic Stability | Age at BNBAS, infant sex, parity, vitamin use, minutes since fed at BNBAS, BNBAS interviewer, illicit drug use during pregnancy. | Age at BNBAS, examiner, smoking during pregnancy, PON1 enzyme tertiles, urinary creatinine. | ||
| Number of Abnormal Reflexes | Age at BNBAS, maternal age at delivery, smoking, vitamin use, BNBAS interviewer, mean diastolic and systolic blood pressure. | Examiner, anesthesia during delivery, PON1 enzyme tertiles, urinary creatinine. | ||
Abbreviations: DAPs=total dialkyl phosphates; DEPs=diethylphosphates; CI=confidence interval; RR=relative risk.
a
“Poisson regression was used to analyze the relation between biomarker levels and the number of abnormal reflexes because of the count nature of the data.”
b
ln the CHAMACOS study (Young et al. 2005), the median age at administration of the BNBAS was 3 days, with an interquartile range between 1 and 26 days post-delivery.
*
p<.05, significance bolded for emphasis.
**
The same covariates were included in the models for DEPs and DAPs within each paper.