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Developmental trajectories of children with birth asphyxia through 36months of age in low/low–middle income countries
Open accessAbstract
Background Resuscitation following birth asphyxia reduces mortality, but may be argued to increase risk for neurodevelopmental disability in survivors. Aims To test the hypothesis that development of infants who received resuscitation following birth asphyxia is not significantly different through 36months of age from infants who had healthy births. Study design Prospective observational cohort design comparing infants exposed to birth asphyxia with resuscitation or healthy birth. Subjects A random sample of infants with birth asphyxia who received bag-and-mask resuscitation was selected from birth records in selected communities in 3 countries. Exclusion criteria birth weight<1500g, severely abnormal neurological examination at 7days, mother<15years, unable to participate, or not expected to remain in the target area. A random sample of healthy-birth infants (no resuscitation, normal neurological exam) was also selected. Eligible=438, consented=407, and ≥1 valid developmental assessment during the first 36months=376. Outcome measure(s) Bayley Scales of Infant Development-II Mental (MDI) and Psychomotor (PDI) Development Index. Results Trajectories of MDI (p=.069) and PDI (p=.143) over 3 yearly assessments did not differ between children with birth asphyxia and healthy-birth children. Rather there was a trend for birth asphyxia children to improve more than healthy-birth children. Conclusions The large majority of infants who are treated with resuscitation and survived birth asphyxia can be expected to evidence normal development at least until age 3. The risk for neurodevelopmental disability should not justify the restriction of effective therapies for birth asphyxia.
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Few studies have described the neurological outcomes of infants who required resuscitation at birth in low-resource settings, however the scarce evidence available reported similar findings.
“Few studies have described the neurological outcomes of infants who required resuscitation at birth in low-resource settings, however the scarce evidence available reported similar findings[20–22] and encourages the use of basic resuscitation in such settings.”
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Metadata
- Authors
- Wallander, J. L., Bann, C., Chomba, E., Goudar, S. S., Pasha, O., Biasini, F. J., McClure, E. M., Thorsten, V., Wallace, D., & Carlo, W. A.
- Affiliations
- University of California, Merced (US)
- RTI International (US)
- Centre for Infectious Disease Research in Zambia (ZM)
- Jawaharlal Nehru Medical College (IN)
- Aga Khan University (PK)
- University of Alabama at Birmingham (US)
- Corresponding author
- Wallander, Jan L.
- ORCID
- Venue
- Early Human Development
- Publisher
- Elsevier BV
- Published
- 2014-07
- Volume
- 90
- Issue
- 7
- Pages
- 343-348
- ISSN
- 0378-3782 (ISSN-L)
- PMC
- PMC4097313
- OpenAlex
- W2128322356
- Cited by
- 18
- References
- 32
- Citations by year
- 2026: 2 · 2025: 1 · 2023: 2 · 2022: 3 · 2020: 1 · 2019: 2 · 2018: 3 · 2017: 1 · 2016: 2 · 2014: 1
- FWCI
- 1.25
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Early Human Development (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health (5p20md005049-02)
- Fogarty International Center (R21TW006703, TW006703)
- National Institute on Minority Health and Health Disparities (P20 MD005049)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (U01HD040636, U10HD078437, U01HD040607, U01HD042372, HD40607, U01HD043464, HD43464, HD42372, U24HD092094, HD40636)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
- Keywords
- neonatal asphyxia, neonatal resuscitation, neurodevelopmental outcomes, infant development, Bayley Scales of Infant Development II, mental development index, psychomotor development index, low- and low-middle-income countries, developmental trajectories
- MeSH terms
- Asphyxia Neonatorum, Developmental Disabilities, Child, Preschool, Developing Countries, Humans, India, Infant, Infant, Newborn, Pakistan, Prospective Studies, Psychomotor Disorders, Resuscitation, Zambia, Models, Statistical, Cohort Studies
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