Neurodevelopmental outcomes in infants requiring resuscitation in developing countries

J Pediatr. 2012 May;160(5):781-5.e1. doi: 10.1016/j.jpeds.2011.10.007. Epub 2011 Nov 17.

Abstract

Objective: To determine whether resuscitation of infants who failed to develop effective breathing at birth increases survivors with neurodevelopmental impairment.

Study design: Infants unresponsive to stimulation who received bag and mask ventilation at birth in a resuscitation trial and infants who did not require any resuscitation were randomized to early neurodevelopmental intervention or control groups. Infants were examined by trained neurodevelopmental evaluators masked to both their resuscitation history and intervention group. The 12-month neurodevelopmental outcome data for both resuscitated and non-resuscitated infants randomized to the control groups are reported.

Results: The study provided no evidence of a difference between the resuscitated infants (n = 86) and the non-resuscitated infants (n = 115) in the percentage of infants at 12 months with a Mental Developmental Index <85 on the Bayley Scales of Infant Development-II (primary outcome; 18% versus 12%; P = .22) and in other neurodevelopmental outcomes.

Conclusions: Most infants who received resuscitation with bag and mask ventilation at birth have 12-month neurodevelopmental outcomes in the reference range. Longer follow-up is needed because of increased risk for neurodevelopmental impairments.

Trial registration: ClinicalTrials.gov NCT00639184.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child Development / physiology
  • Developing Countries
  • Developmental Disabilities / diagnosis
  • Developmental Disabilities / epidemiology*
  • Female
  • Humans
  • Incidence
  • India / epidemiology
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Infant, Very Low Birth Weight
  • Learning Disabilities / diagnosis
  • Learning Disabilities / epidemiology
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / epidemiology
  • Neuropsychological Tests
  • Pakistan / epidemiology
  • Reference Values
  • Respiratory Distress Syndrome, Newborn / therapy*
  • Resuscitation / adverse effects*
  • Resuscitation / methods*
  • Risk Assessment
  • Rural Population
  • Severity of Illness Index
  • Survival Analysis
  • Zambia / epidemiology

Associated data

  • ClinicalTrials.gov/NCT00639184