The purpose of the study was to examine the stability of the adrenocortical response to stimulation in the human neonate. Forty-nine healthy newborns were examined twice responding to discharge examinations performed on two consecutive days. The dependent measures were salivary and plasma cortisol and behavioral state. Little evidence of stability was obtained. Instead, the results showed significant elevations in cortisol only in response to the first discharge examination. No significant elevation in cortisol was noted to the second discharge examination although the newborns continued to exhibit behavioral distress. Time since delivery was not a significant factor in producing these results. The findings are discussed with regard to neonatal coping processes and the importance of novelty in regulating increases in adrenocortical activity.

The association between behavioral distress and adrenocortical activity was examined in two experiments with human newborns. In Experiment 1, behavioral and adrenocortical responses to 4 events (circumcision, blood sampling, weighing and measuring, and discharge examination) were compared using a between-subject design. All 4 events elicited fussing and crying and elevations in plasma cortisol; however, differences in behavioral distress among conditions did not reliably predict differences in plasma cortisol. In Experiment 2, nonnutritive sucking was used to effectively reduce behavioral distress, but was not associated with a reduction in the adrenocortical response to stimulation. Finally, using data from both experiments, correlations were computed between behavioral distress and cortisol. Both positive and negative associations were found as a function of the type of stressor and the biomedical status of the newborn.

The Brazelton Neonatal Behavioral Assessment Scale with Kansas Supplement (NBAS-K) was administered midway between feedings to 60 newborns who were between 32 and 122 hours old. 35 of the newborns were classified as extremely healthy and normal (Subgroup I), whereas 25 (Subgroup II) were characterized by slight perinatal problems including gestational age 36-37 weeks or 42+ weeks, and fetal distress during labor. All of the newborns were healthy enough to be cared for in a healthy newborn, Level I nursery. Immediately following administration of the NBAS-K, a blood sample was obtained for plasma cortisol determination. Correlations between behavioral responding on the NBAS-K and levels of plasma cortisol revealed few significant relations for the sample as a whole. When the 2 subgroups were examined separately, a number of significant relations emerged. Newborns in Subgroup I who were more competent in their motor control and state regulation capacities as assessed by Lester's Cluster Scores for the NBAS-K exhibited higher levels of plasma cortisol. In contrast, newborns in Subgroup II who exhibited a greater adrenocortical response to the examination showed more behaviors indicative of high behavioral arousal and distress. This pattern of relations for Subgroup II appeared to be mediated by the number of hours that had elapsed since delivery. As postpartum time increased, the strength of the association between adrenocortical activity and behavioral arousal/distress decreased for Subgroup II. A systems theory approach is used to interpret the difference in patterns of correlations found for the 2 subgroups.

The Brazelton Neonatal Behavioral Assessment Scale with Kansas Supplement (NBAS-K) was administered midway between feedings to 60 newborns who were between 32 and 122 hours old. 35 of the newborns were classified as extremely healthy and normal (Subgroup I), whereas 25 (Subgroup II) were characterized by slight perinatal problems including gestational age 36-37 weeks or 42+ weeks, and fetal distress during labor. All of the newborns were healthy enough to be cared for in a healthy newborn, Level I nursery. Immediately following administration of the NBAS-K, a blood sample was obtained for plasma cortisol determination. Correlations between behavioral responding on the NBAS-K and levels of plasma cortisol revealed few significant relations for the sample as a whole. When the 2 subgroups were examined separately, a number of significant relations emerged. Newborns in Subgroup I who were more competent in their motor control and state regulation capacities as assessed by Lester's Cluster Scores for the NBAS-K exhibited higher levels of plasma cortisol. In contrast, newborns in Subgroup II who exhibited a greater adrenocortical response to the examination showed more behaviors indicative of high behavioral arousal and distress. This pattern of relations for Subgroup II appeared to be mediated by the number of hours that had elapsed since delivery. As postpartum time increased, the strength of the association between adrenocortical activity and behavioral arousal/distress decreased for Subgroup II. A systems theory approach is used to interpret the difference in patterns of correlations found for the 2 subgroups.