Author:
Thomaidis Loretta,Zantopoulos Georgios Zacharias,Fouzas Sotirios,Mantagou Lito,Bakoula Chryssa,Konstantopoulos Andreas
Abstract
Abstract
Background
Although several determinants of global developmental delay (GDD) have been recognized, a significant number of children remain without definitive etiologic diagnosis. The objective of this study was to assess the effect of various prenatal and perinatal factors on the severity and outcome of developmental delay without definitive etiologic yield.
Methods
From March 2008 to February 2010, 142 children with developmental quotient (DQ) <70 and without definitive etiologic diagnosis, were included. Prenatal and perinatal risk factors known to be associated with disordered neonatal brain function were identified. Participants underwent a thorough investigation, an individualized habilitation plan was recommended, and the children were followed-up regularly for a period of 2 < years. The effect of prenatal and perinatal risk factors on the severity and outcome of GDD was assessed by regression analysis.
Results
The mean age at enrolment was 31 ± 12 < months, and the mean DQ 52.2 ± 11.4. Prematurity and intrauterine growth restriction (IUGR) were found to be independently associated with lower DQ values. The mean DQ after the 2-year follow-up was 62.5 ± 12.7, and the DQ difference from the enrollment 10.4 ± 8.9 (median 10; range-10 to 42). DQ improvement (defined as a DQ difference?≥?median) was noted in 52.8% of the children. IUGR, low socio-economic status, and poor compliance to habilitation plan were found to be independently associated with poorer developmental outcomes.
Conclusions
Prematurity and IUGR were found to be significantly and independently related to the severity of GDD in cases without definitive etiologic yield. Poorer 2-year developmental outcome was associated with IUGR, low socioeconomic status and non compliance to habilitation plan. Prematurity was a significant determinant of the outcome only in association with the above mentioned factors.
Publisher
Springer Science and Business Media LLC
Subject
Pediatrics, Perinatology and Child Health
Reference32 articles.
1. Simeonson RJ, Sharp MC: Developmental delays. Primary Pediatric Care. Edited by: Hoekelman RA, Friedman SB, Nelson NM, Seidel HM. 1992, St. Louis: CV Mosby, 867-870. 2
2. Shevell MI: Present conceptualization of early childhood neurodevelopmental disabilities. J Child Neurol. 2010, 25: 120-126. 10.1177/0883073809336122.
3. Shevell MI: Developmental Disabilities. Edited by: Greydanus DE, Patel DR, Pratt HD. 2008, 55: 1071-1089. Global developmental delay and mental retardation/intellectual disability: conceptualization, evaluation and etiology,Pediatr Clin North Am.
4. Shevell M, Ashwal S, Donley D, et al: Quality standards subcommittee of the American academy of neurology; practice committee of the child neurology society: practice parameter: evaluation of the child with global developmental delay: report of the quality standards subcommittee of the American Academy of neurology and the practice committee of the child neurology society. Neurology. 2003, 60: 367-380. 10.1212/01.WNL.0000031431.81555.16.
5. Gottlieb CA, Maenner MJ, Cappa C, Durkin MS: Child disability screening, nutrition, and early learning in 18 countries with low and middle incomes: data from the third round of UNICEF’s multiple indicator cluster survey (2005–06). Lancet. 2009, 374: 1831-1839. 10.1016/S0140-6736(09)61871-7.
Cited by
19 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献