Indicators of Delay in Development in Asphyxiated Infants
DR. MARINA RASSOU *
DEPARTMENT OF PHYSICAL MEDICINE AND REHABILITATION CHRISTIAN MEDICAL COLLEGE VELLORE*
Abstract
Purpose: Early detection plays a major role in treating and following up children with developmental compromises. This study was done to compare the value of Arterial cord blood pH, clinical staging of Hypoxic Ischaemic Encephalopathy (HIE staging according to Sarnat et. al's criteria), S100B (a glial cytosolic protein, a proven neurochemical marker of HIE in asphyxiated Caucasian infants) in predicting developmental delay at six months follow-up in neonates asphyxiated at birth.

Methodology: Neonates, born in the Christian Medical College, Vellore during the period July 2001 to August 2003, with a pH of 7 or less and an Apgar of not more than 3 at 5 minutes were recruited after parental consent. They were assessed using Arterial cord blood pH, clinical HIE staging at 2, 24 and 72 hours after birth and the serum levels of S100B at 2 and 24 hours. The Developmental Quotient was measured at 6 months using the Revised Gesell schedule for developmental assessment. Statistical analysis was done using Open Stats computer package. Statistical significance was taken at p<0.05.

Results: 22 children were recruited. 1 child died at 7 hrs, 3 died between 24 and 72 hrs, 2 more died before 6 months and 2 were lost to follow up. 20 completed the blood tests at 24hrs and 14 completed clinical assessment at 6 months. No statistical significance was found for any of the tests in predicting developmental delay at 6 months. The diagnostic odds ratio for the HIE at 24hrs was 6.

Discussion and Conclusion: Clinical assessment of children at 24hrs was a better indicator of developmental delay at 6 months. The HIE staging can be used to screen for those infants who should be followed up to allow assessment and early treatment.
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