title: Developmental trajectories of children with birth asphyxia through 36 months of age in low/low-middle income countries.
abstract: BACKGROUND
  Resuscitation following birth asphyxia reduces mortality, but may be argued to increase risk for neurodevelopmental disability in survivors.
  
  
  OBJECTIVE
  To test the hypothesis that development of infants who received resuscitation following birth asphyxia is not significantly different through 36months of age from infants who had healthy births.
  
  
  METHODS
  Prospective observational cohort design comparing infants exposed to birth asphyxia with resuscitation or healthy birth.
  
  
  METHODS
  A random sample of infants with birth asphyxia who received bag-and-mask resuscitation was selected from birth records in selected communities in 3 countries.
  
  
  METHODS
  birth weight<1500g, severely abnormal neurological examination at 7days, mother<15years, unable to participate, or not expected to remain in the target area. A random sample of healthy-birth infants (no resuscitation, normal neurological exam) was also selected. Eligible=438, consented=407, and ≥1 valid developmental assessment during the first 36months=376.
  
  
  METHODS
  Bayley Scales of Infant Development-II Mental (MDI) and Psychomotor (PDI) Development Index.
  
  
  RESULTS
  Trajectories of MDI (p=.069) and PDI (p=.143) over 3 yearly assessments did not differ between children with birth asphyxia and healthy-birth children. Rather there was a trend for birth asphyxia children to improve more than healthy-birth children.
  
  
  CONCLUSIONS
  The large majority of infants who are treated with resuscitation and survived birth asphyxia can be expected to evidence normal development at least until age 3. The risk for neurodevelopmental disability should not justify the restriction of effective therapies for birth asphyxia.
authors.affiliation: University of California, Merced, Merced, CA, United States. Electronic address: Jwallander@ucmerced.edu.
authors.forename: Jan L
authors.initials: JL
authors.lastname: Wallander
authors.affiliation: Research Triangle Institute International, Durham, NC, United States.
authors.forename: Carla
authors.initials: C
authors.lastname: Bann
authors.affiliation: Centre for Infectious Disease Research in Zambia, Lusaka, Zambia; University of Zambia, Lusaka, Zambia.
authors.forename: Elwyn
authors.initials: E
authors.lastname: Chomba
authors.affiliation: KLE University's Jawaharlal Nehru Medical College, Belgaum, India.
authors.forename: Shivaprasad S
authors.initials: SS
authors.lastname: Goudar
authors.affiliation: Aga Kahn University Medical College, Karachi, Pakistan.
authors.forename: Omrana
authors.initials: O
authors.lastname: Pasha
authors.affiliation: University of Alabama at Birmingham, Birmingham, AL, United States.
authors.forename: Fred J
authors.initials: FJ
authors.lastname: Biasini
authors.affiliation: Research Triangle Institute International, Durham, NC, United States.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: McClure
authors.affiliation: Research Triangle Institute International, Durham, NC, United States.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Thorsten
authors.affiliation: Research Triangle Institute International, Durham, NC, United States.
authors.forename: Dennis
authors.initials: D
authors.lastname: Wallace
authors.affiliation: Centre for Infectious Disease Research in Zambia, Lusaka, Zambia; University of Alabama at Birmingham, Birmingham, AL, United States.
authors.forename: Waldemar A
authors.initials: WA
authors.lastname: Carlo
mesh_terms: D001238:Asphyxia Neonatorum / Q000150:complications* / Q000453:epidemiology*; D002675:Child, Preschool; D015331:Cohort Studies; D003906:Developing Countries; D002658:Developmental Disabilities / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D015233:Models, Statistical; D010154:Pakistan / Q000453:epidemiology; D011446:Prospective Studies; D011596:Psychomotor Disorders / Q000453:epidemiology* / Q000209:etiology; D012151:Resuscitation / Q000009:adverse effects*; D015024:Zambia / Q000453:epidemiology
keywords: Birth asphyxia; Developmental outcomes; Low resource countries; Neurodevelopmental disability; Resuscitation