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THE INITIAL CRY OF THE NEW-BORN, A POSSIBLE MARKER OF THE NEONATAL NEUROLOGICAL STATUS

1, C.Ilie

E.

1, Bernad

I.

1, Enatescu

V.R.

3, Enatescu

R.

2 Ilie

1University

of Medicine and Pharmacology V. Babes, Neonatology Department, Timisoara, Romania, 2Children Hospital Louis Turcanu, Pathology Department, Timisoara, Romania, 3University of Medicine and Pharmacology V. Babes, Psychiatry Department, Timisoara, Romania

Introduction. Objective.
The newborns cry represents a biological individual high utility practice sign. Its analyze could represent a precious non invasive diagnostic method and even help to monitor the postnatal neurological sufferance. The aim of the study is to present some variables of the spontaneous and caused cry on healthy, on term, newborns.

Material and method.


It has been recorded the spontaneous cry of the healthy newborns on term, between 1-4 days after birth. The duration of a record was minimum 3 minutes. Tab. 1 and 2 illustrates the lot inclusion criteria and main characteristics. The registration was made case by case, in a place specially prepared for this, with 5-10 minutes before the newborn has been breastfed. From the the studied consignment, on a number of 30 randomly selected newborns has been registered the cry of pain caused by pricking the heel in the neonatal screening; these recordings were made in fourth day of at least 2 hours after the last breastfeedng. For the recording, we used a SEENHEISER EW100 G2 microphone and a SONY HDR FX 1E video cammera and for data storrage we used a PC unit with digital capture board. For the spectrographic analysis and sonor signal processing we used an aplication-MATLAB which uses a record frequency of 64 KH.
Tab. 1. Lot inclusion criteria Without pathological antecedents.

Results
parenteral and heredo-collateral

Tab. 2. The main characteristic for infant subjects

APGAR score 9 and 10 at 1 5 10 minutes. Clinical and neurological exam on birth, normally. Without neonatal pathology on staying time and after going home. Exclusively breast feeding. Clinical and neurological at 1 month reevaluation, normal. Fig. 1. Spontaneous Cry-SPECTROGRAM A

The newborn cry scrolls in rounds with brakes between them and variable duration. It is a signal of non-verbal communication. Through linguistic analogy, a cry sequence is a sentence, a complex analysis unit consisting of more words; the word means the duration of the vocalization during of a single expiration. The sonor signal may be represented graphically through waves where the number of waves mouvement in a second is the fundamental frecvency (F0) and is expressed in cycles/sec or Hertz. F0 variations depending on time covers a wide range of frecquencyes, from the highest (>3000 Hz) to the lowest (<500 Hz).

The crying amplitude is measured in decibels. The fecquencye variation and sonor signal amplitude deppending on time factor represents the visual diagram of the noise signal or spectrogram.
Fig. 2. Caused Cry-SPECTROGRAM A B

C Legend: A=Sentence, B=Word C,D=Frequency spectrum

We registered a very large number of individual spectrograms (sentences and words) which follow to be processed. Until now, we have only analysed one individual spectrogram represented by the initial cry, namely the one from the begining of the record (the first words). The main comparatively analysed parameters for spontaneous vs. caused voice emission are represented in the table 3. The preliminary results sustain the research premise (the newborn cry represents a neurological status marker) and the final aim, the one to realize a standard matrices for healthy newborns cry.

MEAN Tab. 3 Spontaneous Cry, N=122 1.32 Caused Cry, N=30 2,24 Spontaneous Cry, N=122 0,20

DS Caused Cry N=30 0,25

The Duration of the Cry (first word) The Duration between the Cries Base frequency

0,08 813,37

0,44 904,43

0,03 311,41

0,25 233,45

Conclusions:
1. The study method is efficient, cheap and totally non-invasive, if we refer to the standard registration. 2. Through the standard diagrams, the study results allowed to put the method between the large group of the screening test. 3. For validation is necessary the comparison of the results with the initial cry registration of the new-born suffering of perinatal neurological diseases.

Acknowledgments: University of Medicine and Pharmacology V. Babes, Timisoara, Romania. Work supported by Research Grant A: Nr.
755/2006-New directions and management of the perinatal cerebral distress and the postnatal consequences of it;

contact: e-mail : constantinilie@umft.ro