784 - Abnormal Infant Neurobehavior Profiles Following Low-to-Moderate Prenatal Alcohol Exposure

Publication Number: 784.3921

Jessie Maxwell, University of New Mexico School of Medicine, Albuquerque, NM, United States; Melissa H. Roberts, University of New Mexico, Albuquerque, NM, United States; Jean R. Lowe, University of New Mexico School of Medicine, Albuquerque NM, NM, United States; Xingya Ma, university of New Mexico, Albuquerque, NM, United States; Jillian F. Kotulski, University of New Mexico School of Medicine, Albuquerque, NM, United States; Amy L. Salisbury, Virginia Commonwealth University, Richmond, VA, United States; Ludmila N.. Bakhireva, University of New Mexico Health and Health Sciences, Albuquerque, NM, United States

Background: Prenatal alcohol exposure (PAE) has lifelong consequences on affected individuals with a range of physical, neurodevelopmental, learning, and behavioral adverse outcomes. There is no method to identify children at risk of these outcomes shortly after birth resulting in delayed diagnosis and access to therapeutic modalities. The Neonatal Intensive Care Unit (NICU) Network Neurobehavioral Scale, First Edition (NNNS-I) has demonstrated utility in risk stratification of substance-exposed infants but has not been previously used to assess infants with PAE.

Objective: The purpose of this study was to assess utility of NNNS-I in identification of infants with low-to-moderate PAE.

Design/Methods: The Ethanol, Neurodevelopment, Infant and Child Health (ENRICH-2) prospective cohort included maternal assessments in the second and third trimesters of pregnancy, and infant assessments at birth. PAE was evaluated by prospective, repeated Timeline Follow Back interviews and a comprehensive panel of ethanol biomarkers. During the birth hospitalization, certified examiners completed the NNNS-I assessment, which included infant neurobehavioral organization summarized into 13 summary scores. Summary scores and profiles, generated by the latent profile analysis (LPA), were compared among PAE and no-PAE groups.

Results: This analysis included 130 caregiver-infant dyads (71 with PAE and 59 with no-PAE). The absolute alcohol ounces per day in the PAE group was 0.08  0.11 on average, or ~1.1 standard drinks per week. Infants with PAE had significantly lower attention, lower stress abstinence, higher lethargy, and were hypertonic on NNNS-I scales compared to no-PAE infants (all p’s < 0.05). LPA identified 3 profiles of neurobehavior. Profile 1 had the highest percentage of participants with positive ethanol biomarkers and was associated with poor infant self-regulation and decreased attention.

Conclusion(s): Low-to-moderate PAE was associated with neurobehavioral findings identifiable on the NNNS-I assessment highlighting its utility for risk stratification of infants with PAE shortly after birth.