Developmental trajectories of children with birth asphyxia through 36 months of age in low/low-middle income countries (original) (raw)
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Impact of Early intervention in the developmental outcome of Infants with Birth asphyxia
Background: Despite advances in perinatal care over the past three decades, the incidence of birth asphyxia has not changed. In developing countries, the incidence of post asphyxiate neurological damage is extremely high. Neonatal brain damage due to Birth asphyxia is a primary cause of cerebral palsy, mental retardation. Objective: To study the impact of early intervention in the developmental outcome of infants with birth asphyxia till one year of life. Design: This study had conducted on 48 newborns with birth asphyxia who got admitted in neonatal Intensive Care Unit (NICU) of Rajah Muthiah Medical College& Hospital (RMMC&H). Fifty normal newborns age and weight matched served as control. The infants in the study group received early intervention. Denver developmental screening test (DDST) had administered to both groups every four months of age till one year. The results have compared with regard to the various domains. Results: There is a significant difference with regard to four domains namely gross motor fine motor personal social and language. The magnitude of the observed domains differs significantly between the treated birth asphyxia infants and the normal infants. The difference in mean values of the four domains gradually narrowed by one year of life in birth asphyxia infants. Conclusion: The early physical therapy program for infants with birth asphyxia in developmental outcome after one year of age has improved when compared to normal infants.
Birth asphyxia survivors in a developing country
Journal of Perinatology, 2009
Objective-Determine the baseline incidence of birth asphyxia in neonatal intensive care unit (NICU) survivors in a developing country and the early neurodevelopmental outcomes of such infants.
The Journal of Pediatrics, 2012
Study design This was a parallel group, randomized controlled trial of infants unresponsive to stimulation who received bag and mask ventilation as part of their resuscitation at birth and infants who did not require any resuscitation born in rural communities in India, Pakistan, and Zambia. Intervention infants received a parent-implemented EDI delivered with home visits by parent trainers every other week for 3 years starting the first month after birth. Parents in both intervention and control groups received health and safety ...
Neurodevelopmental Outcomes in Infants Requiring Resuscitation in Developing Countries
The Journal of pediatrics, 2011
OBJECTIVE: To determine whether resuscitation of infants who failed to develop effective breathing at birth increases survivors with neurodevelopmental impairment. STUDY DESIGN: Infants unresponsive to stimulation who received bag and mask ventilation at birth in a resuscitation trial and infants who did not require any resuscitation were randomized to early neurodevelopmental intervention or control groups. Infants were examined by trained neurodevelopmental evaluators masked to both their resuscitation history and intervention ...
Indian Journal of Applied Research, 2013
Background: Despite advances in perinatal care over the past three decades, the incidence of birth asphyxia has not changed. In developing countries, the incidence of post asphyxiate neurological damage is extremely high. Neonatal brain damage due to Birth asphyxia is a primary cause of cerebral palsy, mental retardation. Objective: To study the impact of early intervention in the developmental outcome of infants with birth asphyxia till one year of life. Design: This study had conducted on 48 newborns with birth asphyxia who got admitted in neonatal Intensive Care Unit (NICU) of Rajah Muthiah Medical College& Hospital (RMMC&H). Fifty normal newborns age and weight matched served as control. The infants in the study group received early intervention. Denver developmental screening test (DDST) had administered to both groups every four months of age till one year. The results have compared with regard to the various domains. Results: There is a significant difference with regard to four domains namely gross motor fine motor personal social and language. The magnitude of the observed domains differs significantly between the treated birth asphyxia infants and the normal infants. The difference in mean values of the four domains gradually narrowed by one year of life in birth asphyxia infants. Conclusion: The early physical therapy program for infants with birth asphyxia in developmental outcome after one year of age has improved when compared to normal infants. Key words: Birth Asphyxia, Early intervention, Developmental Outcome
Assessment of Risk Factors and Prognosis in Asphyxiated Infants
Iranian Journal of Pediatrics, 2015
Background: Asphyxia is considered an important cause of morbidity and mortality in neonates. This condition can affect many vital organs including the central nervous system and may eventually lead to death or developmental disorders. Objectives: Considering the high prevalence of asphyxia and its adverse consequences, the present study was conducted to evaluate the risk factors for birth asphyxia and assess their correlation with prognosis in asphyxiated infants. Patients and Methods: This two-year follow-up cohort study was conducted on 260 infants (110 asphyxiated infants and 150 healthy neonates) at Mashhad Ghaem Hospital during 2007-2014. Data collection tools consisted of a researcher-designed questionnaire including maternal and neonatal information and clinical/laboratory test results. The subjects were followed-up, using Denver II test for 6, 12, 18, and 24 months (after discharge). For data analysis, t-test was performed, using SPSS version 16.5. P value ≤ 0.05 was considered statistically significant. Results: Of 260 neonates, 199 (76.5%) and 61 (23.5%) cases presented with normal neonatal outcomes and with abnormal neonatal outcomes (developmental delay), respectively. Variables such as the severity of asphyxia (P = 0.000), five-minute Apgar score (P = 0.015), need for ventilation (P = 0.000), and severity of acidosis at birth (P = 0.001) were the major prognostic factors in infants with asphyxia. Additionally, prognosis was significantly poorer in boys and infants with dystocia history (P = 0.000). Conclusions: Prevalence of risk factors for developmental delay including the severity of asphyxia need for mechanical ventilation, and severity of acidosis at birth, dystocia, and Apgar score were lower in surviving infants; therefore, controlling these risk factors may reduce asphyxia-associated complications.
African Health Sciences, 2019
Background: Birth asphyxia (BA) is a preventable cause of cerebral insults in newborns. It is associated with high morbidity and mortality. Of the 120 million babies born in third world countries annually, it is estimated that about 3.6 million will develop BA. Objectives: We aimed to determine the short term outcome and predictors of survival among birth asphyxiated babies using Apgar score. Methods: This study was carried out in the Newborn Unit of Enugu State University Teaching Hospital. In-hospital deliveries (Inborn) and those from other centers (Out-born) with one minute Apgar score ≤ 6 were included. Interviewer administered questionnaire was used to collect data from caregivers. Information sought included gestational age (GA), birth weight (BW), Apgar score, place of delivery and outcome. Data was analyzed using SPSS. Bivariate and multivariate logistic regressions were done. Results: Of the 150 neonates, 61.3% survived. Majority of the dead were out-born. The difference was statistically significant (p < 0.001). The inborn were about 1.2 times (AOR = 1.22; 95% CI: 1.06-1.78) more likely to survive BA. Among low birth weights (LBWs), 73.9% died, 23.7% of normal weights and 14.3% of macrosomics died. The difference was statistically significant (p < 0.001). The normal weights were about 2 (AOR = 2.23, 95% CI: 1.76-6.25) and the macrosomics about 5 times more likely to survive BA than LBWs. Regarding GA, 78.8%, 17.2% and 18.2% of the pre-terms, term and postdates died respectively. The difference was statistically significant (p < 0.001). The term babies were about 11 (AOR = 11.27; 95% CI: 4.02-31-56) and postdates about 9 (AOR = 8.79; 95% CI: 1.43-54.04) times more likely to survive BA than preterms. Other significant factors were degree of asphyxia (p = 0.003), and parental education (p < 0.001). Conclusion: BW, GA, degree of asphyxia, place of delivery and parental education all predicts survival among birth asphyxiated newborns.
Early Human Development, 1991
Twenty-eight term neonates with severe perinatal asphyxia were referred to a tertiary neonatal intensive care unit (NICU). The morbidity of asphyxia included involvement of the pulmonary (n = 24 infants), central nervous system (n = 22), renal (n = 15), cardiac (n = 14), metabolic (n = 13) and hematologic (n = 10) systems. The majority of neonates had more than three organ systems involved. Twenty-four neonates survived the neonatal course and at NICU discharge all system effects other than the central nervous system had resolved. At 5 years (60 months), 14 children had a normal neurologic examination, 9 had spastic quadriplegia and one had hemiplegia. Nine children had a McCarthy General Cognitive Index (GCI) 1 84, 3 had a GCI between 68 and 83 and 12 scored < 67. Neonatal seizures, renal problems, microcephaly at 3 months, and post-neonatal seizures were associated with an abnormal neurologic outcome or a GCI < 67. A neurologic examination during the first year of life may reveal whether children with birth asphyxia will be relatively normal at age 5 years or whether they will show considerable delay. asphyxia; multisystem involvement; neurodevelopmental sequelae.