Neurodevelopmental Outcomes in Infants Requiring Resuscitation in Developing Countries

Abstract

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. Infants were evaluated by trained neurodevelopmental evaluators masked to both their resuscitation history and intervention group. The 12-month neurodevelopmental outcome data for both resuscitated and non-resuscitated infants randomized to the control groups are reported. Results The study provided no evidence of a difference between the resuscitated (N = 86) and the non-resuscitated infants (N = 115) in the percentage of infants at 12 months with a mental developmental index < 85 on the Bayley Scales of Infant Development-II (primary outcome) (18% versus 12%; p = 0.22) and in other neurodevelopmental outcomes. Conclusions The overwhelming majority of infants who received resuscitation with bag and mask ventilation at birth have 12-month neurodevelopmental outcomes in the normal range. Longer follow-up is needed because of increased risk for neurodevelopmental impairments.

Developmental trajectories of children with birth asphyxia through 36months of age in low/low–middle income countries

“…These findings of no differences between resuscitated and not resuscitated children add to previous findings from this research that resuscitated infants’ development at 12 months is not different from that of not resuscitated infants 26 by extending outcome through 36 months of age and examining developmental trajectories over time. Participants were part of a large international study in which training of birth attendants in neonatal resuscitation and other essential newborn care skills reduced stillbirths and perinatal mortality.…”

Stillbirth and Newborn Mortality in India After Helping Babies Breathe Training

“…Resuscitation training improved recognition that some nonbreathing infants are not SB and promoted intervention for infants with apnea at birth, and reduced predischarge asphyxia deaths without increasing NMR. Elevated NMR might be expected if HBB training and resuscitation efforts improve immediate survival of precarious newborns, but death might be deferred only among some of these infants; although unlikely, 30 use of the study facilities by women from neighboring districts from another state, among whom postdischarge loss to follow-up was high because they are not included in the Belgaum registry and could not be reached by telephone.…”

Maternal methylmercury exposure through rice ingestion and offspring neurodevelopment: A prospective cohort study

“…The primary outcome measure was children's cognitive and psychomotor abilities, assessed using the Bayley Scales of Infant Development (BSID)-II, which yields age-adjusted scores for the Mental Developmental Index (MDI) and the Psychomotor Developmental Index (PDI) (Bayley 1993). The BSID-II underwent extensive pre-testing, and a few items were slightly modified to make the BSID-II more culturally appropriate (e.g., image of a Chinese-style home rather than a western-style home), which was consistent with the approach used in other studies in developing countries where the BSID-II was implemented (e.g., India, Pakistan and Zambia, from Carlo et al 2012). Only one evaluator administered the BSID-II, who spoke the local dialect and completed extensive training in BSID-II administration, and was unaware of the children's prenatal MeHg exposure level.…”