Related Experiment Videos
Early detection of preschool health problems--role of perinatal risk factors
Insights
A perinatal risk-grouping system was evaluated in 1,262 children. The system showed weak correlations between perinatal risks and later health problems, indicating a need for comprehensive health surveillance.
Area of Science:
- Pediatrics
- Public Health
- Developmental Pediatrics
Background:
- Perinatal risk-grouping systems aim to identify infants at high risk for later health issues.
- Early identification is crucial for timely intervention and improved child health outcomes.
- Existing systems require validation to ensure their effectiveness in diverse populations.
Purpose of the Study:
- To evaluate the efficacy of a perinatal risk-grouping system in predicting health problems at age four.
- To assess the correlation between perinatal risk factors and the development of physical, visual, and neurological disorders.
- To determine if socioeconomic status influences the predictive power of the risk-grouping system.
Main Methods:
- A cohort of 1,262 children underwent comprehensive health examinations at four years of age.
- Data on perinatal risk factors, including maternal age and socioeconomic status, were collected.
- Statistical analyses were performed to examine correlations between perinatal risks and health outcomes.
Main Results:
- 41.5% of newborns met the broad criteria for perinatal risk, with higher prevalence in boys and children of very young or older mothers.
- 15.8% of four-year-olds had significant health problems, including visual disturbances (10.1%) and neurological disorders (2%).
- Statistically significant correlations were found for some risk-outcome pairs (e.g., prematurity and cerebral palsy), but the system lacked sufficient predictive power for screening.
Conclusions:
- The evaluated perinatal risk-grouping system is not a sufficient screening instrument for identifying children with later health problems.
- Neither the accumulation of serious perinatal events nor the inclusion of low socioeconomic status improved predictive accuracy.
- Comprehensive health surveillance, including clinical examinations and screening by trained personnel, remains the most reliable method for detecting health issues in children.
Abstract:
To evaluate a perinatal risk-grouping system, 1 262 4-year-old children went through a comprehensive health examination. A total of 41.5% of the newborns were included in the wide criteria of risk, which were more common among boys and among children of the youngest and oldest mothers. Among the 4-year-old, the frequency of significant physical health problem was 15.8%, including 10.1% visual disturbances and 2% neurological disorders. In some combinations of risk groups and later health problems there were statistically significant correlations, e.g. regarding prematurity and cerebral irritation vs. cerebral palsy, but not sufficient to serve its purpose as a screening instrument. Even the accumulation of especially serious events in the perinatal period gave no clue to later neurological disorders. The addition of low socioeconomic status as a perinatal risk did not influence the outcome either. The reasons for the weak correlation between perinatal risk factors and later outcome of health disorders and handicaps are discussed, and it is concluded that to detect children with health problems, there seems to be no acceptable alternative to a comprehensive health surveillance as part of a general health service programme of all children, including clinical examinations and screening procedures by well trained personnel.