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Published on: August 25, 2014
Predictors of Suspected Developmental Delay Identified Through Screening During the First Year of Life Among Special
Girish K Sharma1, Vandana Sharma2, Sanjeev Chaudhary1
1Pediatrics, Dr. Radhakrishnan Government Medical College, Hamirpur, IND.
Insights
Approximately 7.1% of infants discharged from special newborn care units (SNCUs) showed suspected developmental delay. Neonatal resuscitation and low birth weight were key predictors, highlighting the need for developmental screening in rural health systems.
Area of Science:
- Neonatal care and developmental pediatrics.
- Public health and epidemiology in rural settings.
Background:
- Special newborn care units (SNCUs) have improved survival rates for neonates in India.
- Limited data exists on developmental outcomes for SNCU graduates, especially in rural areas.
Purpose of the Study:
- To determine the prevalence of suspected developmental delay in infants up to 12 months old discharged from a rural SNCU.
- To identify neonatal risk factors associated with developmental delay in these infants.
Main Methods:
- A prospective follow-up study of 113 infants discharged from a rural tertiary care hospital's SNCU.
- Developmental screening using the Trivandrum Developmental Screening Chart (TDSC).
- Analysis of maternal and neonatal risk factors using chi-square/Fisher's exact test and logistic regression.
Main Results:
- Suspected developmental delay was found in 7.1% of infants (8 out of 113).
- Low birth weight, prematurity, maternal hypothyroidism, and neonatal resuscitation were associated with delay on univariate analysis.
- Neonatal resuscitation (aOR 4.12) and low birth weight (aOR 3.21) were independent predictors of suspected developmental delay.
Conclusions:
- About 1 in 14 SNCU graduates exhibited suspected developmental delay by one year of age.
- Neonatal resuscitation and low birth weight are significant independent predictors.
- Emphasizes the necessity of structured developmental screening and follow-up for high-risk neonates in primary and rural healthcare.
Background:
Expansion of special newborn care units (SNCUs) in India has improved neonatal survival. However, information regarding post-discharge suspected developmental delay outcomes among SNCU graduates remains limited, particularly in rural settings.
Objective:
This study aimed to determine the prevalence of suspected developmental delay among infants ≤12 months of age discharged from an SNCU through screening and to identify associated neonatal risk factors.
Methods:
This hospital-based prospective follow-up study included 113 infants discharged from the SNCU of a rural tertiary care hospital in North India. Suspected developmental delay was assessed using the Trivandrum Developmental Screening Chart (TDSC), a validated screening tool. Infants who screened positive were considered to have suspected developmental delay. Maternal and neonatal risk factors were recorded. Associations were analyzed using chi-square/Fisher's exact test and multivariate logistic regression.
Results:
Suspected developmental delay based on TDSC screening was identified in eight of 113 infants (7.1%). On univariate analysis, low birth weight (<2.5 kg), prematurity (<37 weeks), maternal hypothyroidism, and neonatal resuscitation were significantly associated with suspected developmental delay (p<0.05). On multivariate analysis, neonatal resuscitation (adjusted odds ratio (OR) 4.12; 95% confidence interval (CI) 1.18-14.32; p=0.026) and low birth weight (adjusted OR 3.21; 95% CI 1.05-9.81; p=0.041) remained independent predictors.
Conclusion:
Approximately one in 14 infants discharged from the SNCU showed suspected developmental delay based on screening at one year of age. Neonatal resuscitation and low birth weight were independent predictors. These findings highlight the need for structured developmental screening and follow-up of high-risk neonates within primary care and rural health systems.
