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Evaluation of the routine examination of nine month old infants
1Research and Education Unit, Royal New Zealand Plunket Society, Dunedin.
Insights
A 1988 New Zealand study found that 8.3% of nine-month-old infants had previously unknown health conditions. Pacific Island infants showed higher abnormality rates, highlighting the need to reassess infant examination policies.
Area of Science:
- Pediatrics
- Public Health
- New Zealand Health Policy
Background:
- Routine infant examinations are crucial for early detection of health issues.
- Understanding ethnic variations in infant health is vital for targeted healthcare.
- The role of healthcare professionals in infant assessments requires ongoing evaluation.
Purpose of the Study:
- To evaluate the effectiveness and findings of the nine-month infant examination in New Zealand.
- To identify the prevalence of previously unknown conditions in infants.
- To analyze variations in findings based on ethnicity and examiner type.
Main Methods:
- A cohort of 1027 infants born in June 1987 in New Zealand were followed.
- 880 infants (85.6%) underwent a nine-month examination by Plunket nurses or pediatricians.
- Data collected included infant ethnicity, presence of abnormalities, and other health concerns.
Main Results:
- Previously unknown conditions requiring further assessment were found in 8.3% of infants.
- Pacific Island infants had the highest rate of abnormalities (18.3%), followed by Maori (10.1%) and European (7.3%).
- Examiner type (nurse vs. pediatrician) and maternal health issues did not significantly alter findings across ethnic groups.
Conclusions:
- The nine-month infant examination is valuable and should continue.
- Current recommendations prioritizing general practitioners for these examinations should be reconsidered.
- Ethnic disparities in detected abnormalities warrant further investigation and potentially tailored screening approaches.
Abstract:
During the month of March 1988, 880 (85.6%) of the 1027 babies born in New Zealand during the first week of June 1987 were examined by either a Plunket nurse or a paediatrician. Sixty-nine percent of the babies were European, 16.9% Maori, 6.8% from the Pacific Islands and 4.4% other nationalities. Previously unknown conditions or abnormalities that required further assessment or treatment were discovered in 8.3% of babies. Abnormalities were found in: 7.3% of European infants; 10.1% of the Maori infants; 18.3% of the Pacific Island infants and 2.6% of the others. Other topics considered of significance to the examiner but not directly associated with the nine month examination (eg, maternal health problem), were recorded in 24% of cases. There was no significant difference across the three main ethnic groups. Similar results were recorded irrespective of whether the examination was undertaken by a doctor or a nurse. We believe the nine month examination should be continued but the present policy of recommending that preferably general practitioners carry out the examination should be reassessed.