Adrenocortical Activity and the Brazelton Neonatal Assessment Scale: Moderating Effects of the Newborn's Biomedical Status

Abstract

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.

Emotion dysregulation as a risk factor for child psychopathology.

“…In populations at higher risk for the development of behavioral and emotional problems, there may be a stronger association among biological and behavioral measures, as well as higher stability of distress behaviors across development. For example, Gunnar, Isensee, and Fust (1987) found that correlations between cortisol levels and arousal items from the Neonatal Behavioral Assessment scale (NBAS) were stronger for a more heterogeneous group of neonates (with regard to perinatal problems) than a group of homogeneous, low‐risk neonates.…”

The Hurst Exponent of Heart Rate Variability in Neonatal Stress, Based on a Mean-Reverting Fractional Lévy Stable Motion

“…If exposed to acute stress, like a simple heel prick blood drawing, the newborn goes through significant physiological changes. The infants start crying, but in behind the curtains the activation of the hypothalamic-pituitary-adrenocortical (HPA) system goes on [21,10]. Serum catecholamine and glucocorticoid levels rise, the sympathetic of the autonomic nervous system rises, both the heart and blood pressure increase, the heart rate variability, respiration rate and respiration movements change etc.…”