Relationship between severe acidemia, verbal abilities, and behavior in a Spanish cohort of 5-year-old children born at term.
OBJECTIVE
To determine whether a relationship exists between the markers of severe acidemia (SA) and the developmental, verbal, and behavioral characteristics of children with SA born at term 5 years previously, without apparent neurological impairment.


METHODS
A cohort of 76 children-38 with SA (pH < 7, base deficit ≥12 mmol/L) and 38 non-SA (pH ≥ 7.20)-were evaluated using the Battelle Developmental Inventory, McCarthy's Verbal Scale, the Token Test for Children, and the Conners 3rd Edition-Parent. The relationships between markers of SA and verbal and behavioral scores were analyzed with parametric correlations. Multiple regression analysis was used to determine the possible effect of these markers on verbal abilities, verbal memory, and attention.


RESULTS
Although none of the scores were in the "impaired" range, the SA group scored lower in verbal index (p = .000) and verbal memory (p = .004) on the McCarthy's Scales and in verbal comprehension (p = .001) on the Token Test for Children-2, and higher on the inattention (p = .003) and hyperactivity-impulsivity domains of the Conners Scales (p = .009) compared with the control group. There were no differences between the groups in the motor, personal-social, or cognitive domains on the Battelle Developmental Inventory. The SA markers were found to be predictors, accounting for 61.6% of verbal variability.


CONCLUSIONS
SA markers reflect mild long-term consequences regarding verbal abilities and inattentiveness among children born at term without apparent neurological impairment on discharge but do not suggest severe impairment to the 5-year development of children. The authors recommend that these children should be monitored to determine whether they need or might benefit from an early intervention program.
Department of Developmental Psychology and Education, University of Granada, Granada, Spain. mmbellid@ugr.es
Mercedes
M
Bellido González
F Javier
FJ
Pacheco-Sánchez-Lafuente
Carlos
C
Roca-Ruíz
José Antonio
JA
Hurtado-Suazo
Miguel Angel
MA
Díaz-López
D000138:Acidosis / Q000150:complications / Q000209:etiology / Q000523:psychology*; D001034:Apgar Score; D001288:Attention / Q000502:physiology*; D002652:Child Behavior / Q000502:physiology*; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007804:Language Development; D007807:Language Tests; D008297:Male; D009483:Neuropsychological Tests; D012720:Severity of Illness Index; D013030:Spain; D014705:Verbal Behavior / Q000502:physiology*