Table 4.
Fetal neurobehavior and maternal smoking in relation to infant neurobehavior over the first postnatal month, measured by the NICU Network Neurobehavioral Scale (NNNS).
| ATTENTION | HANDLING | LETHARGY | REGULATION | QUALITY OF MOVEMENT | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Parameter | B | SE | P | B | SE | P | B | SE | P | B | SE | P | B | SE | P |
| Fetal Isolated Movements | −0.101 | 0.155 | 0.514 | 0.009 | 0.012 | 0.462 | 0.259 | 0.163 | 0.114 | −0.067 | 0.067 | 0.317 | 0.065 | 0.0274 | 0.017 |
| Maternal Smoking | −0.531 | 0.649 | 0.413 | 0.015 | 0.057 | 0.793 | 0.630 | 0.849 | 0.457 | −0.101 | 0.278 | 0.717 | 0.179 | 0.1541 | 0.245 |
| Infant Age | 0.146 | 0.024 | 0.000 | −0.010 | 0.003 | 0.001 | −0.186 | 0.029 | 0.000 | 0.074 | 0.011 | 0.000 | 0.057 | 0.0076 | 0.000 |
| Maternal Depression | −0.052 | 0.024 | 0.032 | −0.001 | 0.003 | 0.854 | 0.087 | 0.040 | 0.030 | −0.005 | 0.009 | 0.569 | 0.000 | 0.0073 | 0.996 |
| Fetal IM*M-Smoking | 0.371 | 0.232 | 0.109 | −0.028 | 0.020 | 0.172 | −0.471 | 0.264 | 0.074 | 0.109 | 0.103 | 0.290 | −0.014 | 0.0388 | 0.726 |
| Fetal Complex Movements | 0.172 | 0.254 | 0.499 | 0.077 | 0.035 | 0.030 | −0.733 | 0.752 | 0.330 | −0.232 | 0.200 | 0.246 | 0.084 | 0.1887 | 0.657 |
| Maternal Smoking | 0.584 | 0.334 | 0.081 | −0.048 | 0.029 | 0.094 | −0.402 | 0.442 | 0.362 | 0.272 | 0.119 | 0.022 | 0.165 | 0.1024 | 0.107 |
| Infant Age | 0.138 | 0.025 | 0.000 | −0.010 | 0.003 | 0.002 | −0.186 | 0.029 | 0.000 | 0.075 | 0.011 | 0.000 | 0.056 | 0.0077 | 0.000 |
| Maternal Depression | −0.050 | 0.024 | 0.036 | −0.001 | 0.003 | 0.838 | 0.093 | 0.039 | 0.018 | −0.007 | 0.009 | 0.427 | 0.005 | 0.0074 | 0.538 |
| Fetal CBM*M-Smoking | −1.125 | 1.135 | 0.322 | −0.040 | 0.178 | 0.823 | −1.446 | 1.323 | 0.274 | −0.972 | 0.410 | 0.018 | −0.264 | 0.4602 | 0.567 |
| Fetal Quality of Movement | 0.061 | 0.305 | 0.842 | −0.001 | 0.034 | 0.986 | −0.281 | 0.390 | 0.471 | 0.064 | 0.141 | 0.647 | −0.216 | 0.1225 | 0.078 |
| Maternal Smoking | 4.620 | 1.793 | 0.010 | −0.158 | 0.281 | 0.574 | −6.468 | 2.029 | 0.001 | 0.393 | 0.862 | 0.649 | −1.393 | 0.6517 | 0.033 |
| Maternal Depression | −0.048 | 0.024 | 0.050 | −0.001 | 0.002 | 0.631 | 0.083 | 0.040 | 0.040 | −0.003 | 0.009 | 0.787 | 0.055 | 0.0074 | 0.000 |
| Infant Age | 0.135 | 0.024 | 0.000 | −0.009 | 0.003 | 0.005 | −0.186 | 0.029 | 0.000 | 0.073 | 0.012 | 0.000 | −0.001 | 0.0078 | 0.941 |
| FQM *M-Smoking | −0.997 | 0.436 | 0.022 | 0.032 | 0.068 | 0.639 | 1.406 | 0.489 | 0.004 | −0.049 | 0.208 | 0.815 | 0.366 | 0.1523 | 0.016 |
| Fetal Activity | −0.001 | 0.000 | 0.030 | 0.000 | 0.000 | 0.029 | 0.001 | 0.001 | 0.001 | 0.000 | 0.000 | 0.000 | 0.000 | 0.000 | 0.057 |
| Maternal Smoking | 0.783 | 0.231 | 0.001 | −0.061 | 0.027 | 0.025 | −0.439 | 0.309 | 0.155 | 0.210 | 0.121 | 0.084 | 0.250 | 0.103 | 0.015 |
| Infant Age | 0.162 | 0.021 | 0.000 | −0.011 | 0.003 | 0.001 | −0.187 | 0.025 | 0.000 | 0.074 | 0.011 | 0.000 | 0.057 | 0.007 | 0.000 |
| Maternal Depression | −0.039 | 0.020 | 0.056 | −0.001 | 0.003 | 0.645 | 0.109 | 0.031 | 0.000 | 0.000 | 0.010 | 0.978 | 0.003 | 0.009 | 0.733 |
| Fetal Activity*M-Smoking | −0.001 | 0.001 | 0.037 | 0.000 | 0.000 | 0.774 | 0.001 | 0.001 | 0.457 | 0.000 | 0.000 | 0.043 | 0.000 | 0.000 | 0.222 |
| Fetal Coupling Index | 1.169 | 0.561 | 0.037 | −0.240 | 0.075 | 0.001 | −1.336 | 0.750 | 0.075 | 0.551 | 0.311 | 0.076 | −0.571 | 0.1887 | 0.002 |
| Maternal Smoking | −0.185 | 0.610 | 0.761 | −0.175 | 0.065 | 0.007 | 0.069 | 0.795 | 0.931 | 0.256 | 0.281 | 0.363 | −0.213 | 0.1782 | 0.231 |
| Maternal Depression | −0.061 | 0.019 | 0.002 | −0.002 | 0.003 | 0.507 | 0.139 | 0.031 | 0.000 | −0.007 | 0.010 | 0.502 | 0.057 | 0.0071 | 0.000 |
| Infant Age | 0.160 | 0.022 | 0.000 | −0.011 | 0.003 | 0.001 | −0.184 | 0.025 | 0.000 | 0.075 | 0.011 | 0.000 | 0.008 | 0.0083 | 0.343 |
| Fetal Coupling*M-Smoking | 1.246 | 1.025 | 0.224 | 0.230 | 0.104 | 0.027 | −0.634 | 1.274 | 0.619 | −0.126 | 0.485 | 0.795 | 0.698 | 0.3172 | 0.028 |
NOTE: P values highlighted in red, bold indicate statistically significant main or interactive effects of fetal neurobehavior and/or maternal smoking. P values highlighted in black bold indicate statistically significant effects of covariates. Models represent Generalized Estimating Equations (GEE) parameters for models predicting infant neurobehavior over the first postnatal month from fetal neurobehavioral scales and maternal smoking group. Infant second-hand smoke exposure (ETS) was included as a covariate in the Attention, Handling, Lethargy, and Quality of Movement models; maternal caffeine use was included in the Lethargy model. NNNS Attention is a measure of orientation to animate and inanimate auditory and visual stimuli. NNNS Handling is a measure of need for intervention from the NNNS examiner to soothe the infant and assist the infant in maintaining a quiet, alert state. NNNS Lethargy is a measure of infant lethargic behavior or low levels of motor, state and physiologic reactivity. NNNS Self-Regulation measures the infant’s capacity to organize activity, physiology, and state and response to positive and negative stimuli. NNNS Quality of Movement is a measure of maturity of movement patterns, relative proportion of smooth versus jerky movements, startles and tremors, and levels of activity and quiescence. Maternal Smoking=maternal smoking during pregnancy group. Infant Age: modeled in postnatal days. Maternal Depression=score on 21-item Hamilton Depression Rating Scale.