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.
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.
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.
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).
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.
Uno de los instrumentos más utilizados a nivel internacional en la vigilancia del desarrollo del niño es la segunda versión del Denver Developmental Screening Test (DENVER II), del cual se han hecho ...evaluaciones y modificaciones en varios países, a partir de la estimación de la edad de presentación de los reactivos, pues constituye la base de su estructura y validez. Objetivo. Identificar las edades y secuencias de presentación de los reactivos del Test Denver II en los cuatro primeros años de vida en niños de condición socioeconómica baja de una comunidad del Estado de Morelos, México. Método. Se realizaron 2350 evaluaciones a niños de 0 a 48 meses de edad. Mediante un modelo de regresión logística se estimó la edad de presentación de cada reactivo para los percentiles 25, 50, 75 y 90. Se establecieron diferencias con los valores de referencia del instrumento con base en los intervalos de confianza al 95% para el percentil 90. Resultados. De los 98 reactivos evaluados, 42 se presentaron con retraso; 23 no mostraron diferencias estadísticas y 33 se lograron antes por los niños del estudio. En las áreas Motor grueso y Personal-social predominaron los retrasos en 19/25 y 11/21 reactivos respectivamente. Por el contrario en Motor Fino-Adaptativo y Lenguaje predominaron los adelantos en 11 de 22 y 16 de 30 reactivos. Conclusiones. Existen diferencias en las edades y secuencias de presentación de los reactivos del Test de Denver II en la población estudiada. Se recomienda realizar ajustes antes de implementar su uso en contextos socioculturales específicos.
Down’s syndrome (DS) is one of the most common genetic causes of mental and cognitive retardation. In fact, it results in a number of characteristic neuropsychological and physical symptoms, ...including mental retardation. The aim of this study was to compare the brain structure volumes of children with DS to those of healthy children using MRI Studio in order to investigate whether there exists correlation between the developmental stages of DS and the results of both the Denver II Developmental Screening Test and magnetic resonance imaging (MRI) quantitative analysis. Five children diagnosed with Down’s syndrome (age range = 2–6 years) were matched for gender and age with five healthy comparison subjects. To analyse the overall and regional brain volumes, high-resolution MRI scans were performed and a morphometric analysis was conducted via MRI Studio software. The MRI T1 volumetric images were normalised using a linear transformation, which was followed by large deformation diffeomorphic metric mapping. Significant decreases (p<0.05) in the volumes of the right pons, cerebellum and left superior frontal gyrus (prefrontal cortex) were observed in the children with DS when compared with the control group (p<0.05). Although decreases were detected in the regional volumes of other brain locations, they were not significant (p>0.05). It was further found that the developmental retardation observed in the children with DS, as detected using the Denver II test, increased due to decreases in the volumes of certain regions of the brain, although this was also not statistically significant (p>0.05). The results of this study generally confirm the findings of prior studies concerning the overall patterns of the brain volumes in children with DS and also provide new evidence of the abnormal volumes of specific regional tissue components among such a population. These results suggest that the brain volume reduction associated with DS may primarily be due to early developmental differences rather than neurodegenerative changes.
Language delays are common in childhood, may be associated with delays in other areas of development, and can affect school performance. Various tests designed for general developmental screening or ...specifically for language are used to assess developmental status in preschool children. Knowledge of the probabilities of normal developmental milestones may simplify detection of problems and delays. The aim of this study was to determine the milestones of language development in Turkish children.
We assessed data from application of the Denver II Developmental Screening Test's Turkish standardization to 1,993 children, 976 (49.0%) boys and 1,017 (51.0%) girls aged 0.6-82.0 months. We used binary logistic regression to analyze the predicted probability of accomplishing the language items on the Denver II Developmental Screening Test.
We determined the sequence of assessed language items and the ages associated with accomplishing those items, as well as the ages at which 25, 50, 75, and 100% of children passed the items. Language items followed a sequential route. Graphs had polynomial slopes.
Curves for normal development allow detection of aberrations in the predicted course of language development, and may facilitate earlier diagnosis of delays in language.
There are few Brazilian studies on neuropsychomotor follow-up after open-heart surgery with circulatory bypass in infants. Twenthy infants had neurodevelopmental outcomes (neurological exam and ...Denver II test) assessed before open-heart surgery, after intensive care unit discharge and 3-6 months after hospital discharge. Heart lesions consisted of septal defects in 11 cases (55%). The mean circulatory bypass time was 67 ± 23.6 minutes. Fifteen infants had altered neurological examination and also neurodevelopment delay before surgery. After 6 months it was observed normalization in 6 infants. When Denver II test indexes were analysed, it was observed an improvement in all domains except personal-social. Although those infants were in risk of new neurological findings, an early improvement on neuropsychomotor indexes were seen.As alterações neurológicas em lactentes com cardiopatia congênita podem agravar seu quadro clínico e levar a seqüelas permanentes. Foi realizada uma coorte prospectiva, com 20 lactentes, com idade média de 6,7 ± 4,2 meses, avaliando-se o perfil de desenvolvimento e o estado nutricional. Utilizou-se o exame neurológico e o teste de Denver II. Os testes foram aplicados 24h antes da cirurgia, na alta da unidade de terapia intensiva e 3 a 6 meses após. Os defeitos septais ocorreram em 11 casos (55%). O tempo médio de circulação extra-corpórea foi de 67ffl23,6 minutos. Quinze crianças tinham exame neurológico alterado e atraso no desenvolvimento neuropsicomotor antes da cirurgia, cuja normalização foi observada somente em seis após 6 meses .Quanto aos índices de Denver II, houve aumento em todos domínios, exceto o pessoal-social. O escore Z médio para peso antes da cirurgia foi -2,814 ± 1,98 e após -1,08 ± 1,47 (p<0.05), o qual foi realizado em média 5.2 ± 1.5 meses após a alta hospitalar. Melhora precoce tanto no desenvolvimento como no estado nutricional pôde ser observada neste grupo de lactentes após a correção cirúrgica.
There are few Brazilian studies on neuropsychomotor follow-up after open-heart surgery with circulatory bypass in infants. Twenty infants had neurodevelopmental outcomes (neurological exam and Denver ...II test) assessed before open-heart surgery, after intensive care unit discharge and 3-6 months after hospital discharge. Heart lesions consisted of septal defects in 11 cases (55%). The mean circulatory bypass time was 67 +/- 23.6 minutes. Fifteen infants had altered neurological examination and also neurodevelopment delay before surgery. After 6 months it was observed normalization in 6 infants. When Denver II test indexes were analysed, it was observed an improvement in all domains except personal-social. Although those infants were in risk of new neurological findings, an early improvement on neuropsychomotor indexes were seen.
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