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Background: Late preterm infants have higher morbidity in the neonatal period and difficulties at school age. There are few data about neonatal neurobehavior performance that may interfere in their development. Objectives: To compare the neurobehavior of healthy late preterm and full-term neonates born to adolescent mothers. Methods: This prospective cross-sectional study included infants with a gestational age of 40^0/7–40^6/7 weeks (full term) and 34^0/7–36^6/7 weeks (late preterm) aged 24–72 h without exposure to alcohol, tobacco, drugs or infections and free of clinical problems during the first 3 days of life. Infants were assessed with the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS). Outcomes were analyzed by ANOVA. Results: From July 2001 to November 2002, 3,685 infants were born, 928 of adolescent mothers. After exclusion, 36 late preterm and 96 term infants were enrolled. Adjusted for anesthesia type, delivery mode, gender, age at NNNS examination, time between last feeding and examination, and examination duration, late preterm, compared to term neonates, presented lower scores for attention (p = 0.041), arousal (p = 0.011), regulation (p < 0.001), quality of movements (p < 0.001) and higher scores for non-optimal reflexes (p < 0.001) and hypotonicity (p = 0.029). Conclusion: Late preterm infants of adolescent mothers have a more immature neurobehavioral performance at 24–72 h of life in multiple areas compared to term neonates suggesting a need for careful follow-up.

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INTRODUCTION:Prenatal tobacco exposure interferes with neonatal outcomes.OBJECTIVE:To determine the neonatal neurobehavioral effects of in utero tobacco exposure.METHODS:This prospective cross-sectional study included healthy, term, with birth weight appropriate for gestacional age neonates without exposure to alcohol, drugs, or infections, born to adolescent mothers without psychiatric disorders or post-traumatic stress. Infants were classified according to in utero tobacco exposure, as identified by the Composite International Diagnostic Interview administered to mothers. Neurobehavior was assessed by the Neonatal Intensive Care Unit Network Neurobehavioral Scale. Both tools were administered between 24 and 72 hours after birth. Neurobehavioral outcomes were compared between exposed and non-exposed infants by ANOVA. The associations between neurobehavioral scores and number of cigarettes smoked were studied by linear correlation.RESULTS:During the study, 928 newborns of adolescent mothers were born, and 388 were included in the study. Of these, 23 were exposed to tobacco, and 365 neonates were not exposed. There were no differences between the groups in gestational age, birth weight, post-natal age at the exam, or time between last feeding and exam. Exposed neonates showed higher scores on arousal (p = 0.004), excitability (p = 0.003), and stress/abstinence signals (p = 0.019) and a lower score on regulation (p = 0.025). After adjusting for the type of anesthesia, mode of delivery, gender, age at neurologic exam, exam duration and time between last feeding and exam, differences in arousal and excitability remained significant. The mean number of cigarettes consumed daily was positively correlated with lethargy (p = 0.013) and inversely with attention (p = 0.043).CONCLUSIONS:Neonates exposed in utero to tobacco showed worse neurobehavioral performance between 24 and 48 hours of life.