Neurological adaptation of full-term newborn infants : Influence of intrauterine growth accleration, intrapartal asphyxia and different modes of delivery

Abstract: Grace Otamiri. 1991. Neurological adaptation of full-term newborn infants. Influence of intrauterine growth acceleration, intrapartal asphyxia and different modes of delivery.The neurological adaptation was studied in full-term newborn infants of different categories. Mother-infant relationship, neurology and development at 6 months of age were also evaluated. Large-for-gestational age (LGA) infants showed fewer optimal neurological responses on the first day of life, as compared to appropriate-for-gestational age infants, used as controls. There were no neurological differences between prenatally and postnatally detected LOA infants. Infants with intrapartal asphyxia, born after emergency cesarean section (CS) were significantly more hypotone the first 2 days after delivery than infants born after elective CS. When compared with control infants, infants born after elective CS were more hypotone and showed less excitability (alertness) during the first 2 postnatal days and had reduced number of optimal responses during the first 5 days. No neurological differences were found between the CS infants delivered with general or epidural anaesthesia. The follow-up studies at 6 months of age showed no differences in either growth, neurology or development of the infants born after CS, vaginal breech and the controls. The catecholamine levels in cord blood were lower in elective CS infants as compared to vaginally delivered infants. A significant correlation was found between low levels of noradrenaline and poor muscle tonus and low grade of excitability on day 1.Mothers in the elective CS group had significantly more doubts about their capacity to care for their babies at the maternity ward as compared to the controls. However, at 1 month after delivery the elective CS mothers significantly contributed more caretaking for their babies.In conclusion, factors as the fetal size, intrapartal asphyxia and mode of delivery influence the neurological adaptation of full-term infants during the first days of life. The neurological dysfunction was transient and did not affect the health of the infants who all showed normal growth, neurology and psychomotor development at the 6-month follow-up.