Circumcision: Effects upon Newborn Behavior. A controlled, blind, observational study.

Abstract

We report a controlled, blind observational study on the effecs of circumcision (circ.) upon newborn behavior using a new technique which we have developed for reducing Brazelton Neonatal Behavioral Assessment Scale (BNBAS) data into specific behavior categories: average, subdued and hyperactive. Twenty-six normal male infants were randomly assigned to an early-48-hour or delayed 3-wk. circ. group. Each group received 3 BNBAS examinations (E). E1 at a47 hrs., E2 at 50 hrs., and E3 at 72 hrs., in which the examiner was blind to the circ. status of the patient. Circ. was done between E1 and E2 for the early group and after E3 for the delayed group. Ten items were extracted from the BNBAS scores to form our clinical reduction scale - 7 from the behavioral scores, and 3 derived from the summary paragraph recorded at the end of the examination. A significant difference (p<.0001) in the number if infants changing behavior categories between E1 and E2 (3 hrs. was noted: 12/14 (86%) for the early circ. subjects, compared to 2/12 (17%) for the control, delayed circ. subjects. One-third (4/12) of early circ. subjects persisted in their changed behavior for at least 22 hrs. (E3). We have demonstrated: 1) an new technique for applying the BNAS to clinical problems, 2) that nearly 90% of infants show behavior changes after circ., 3) that post-circ. behavior changes are varied, about 60% more and 40% less active, and 4) that investigators of male infant behavior must consider effects of circ. for at least 22 hrs.