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Neonatology
Original article
Assessment of developmental outcome in very low birth weight infants in Southern Africa using the Bayley Scales of Infant Development (III)
  1. Daynia Elizabeth Ballot1,2,
  2. Tanusha Ramdin1,
  3. David Rakotsoane1,
  4. Faustine Agaba1,
  5. Tobias Chirwa3,
  6. Victor Alan Davies1,
  7. Peter Alan Cooper1
  1. 1 Division of Neonatology, Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa
  2. 2 Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
  3. 3 School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
  1. Correspondence to Daynia Elizabeth Ballot; daynia.ballot{at}wits.ac.za

Abstract

Objectives The study aimed to compare the developmental outcome of very low birth weight infants with a group of normal-term controls in a tertiary hospital in sub-Saharan Africa.

Design A group of 105 very low birth weight infants were assessed at a mean age of 17.6 months (95% CI 16.7 to 18.6) using the Bayley Scales of Infant Development, Third Edition, and compared with a group of normal-term controls at the same mean age.

Results Seven of the study infants (7%) had developmental delay (a score below 70), compared with none in the control group (p=0.04). Three of the seven study infants were delayed on all three subscales, one of whom had cerebral palsy. A further 34% of the study infants were ‘at risk’ of developmental delay (a score below 85). There was no difference in the mean composite score between the study group and controls for the cognitive (p=0.56), motor (p=0.57) or language (p=0.66) subscales. There was no difference in mean composite scores on all subscales between infants who were appropriate for gestational age and those who were small for gestational age. Cognitive and motor scores remained stable in paired assessments of study infants before and after 1 year of age; language scores decreased significantly (p<0.001). Mechanical ventilation was the only risk factor significantly associated with a cognitive score below 85 in study infants.

Conclusion Very low birth weight infants in sub-Saharan Africa are at risk of developmental delay and require long-term neurodevelopmental follow-up.

  • neonatology
  • neurodevelopment
  • outcomes research

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjpo-2017-000091

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    Footnotes

    • Contributors DEB conceptualised the study, developed the protocol, collected and analysed data and wrote various drafts and final submission of the manuscript. TR, DR and FA assisted with data collection, write-up and review of drafts and final submission. TC assisted with study concept and design, data analysis and review of drafts and final submission of manuscript. VAD and PAC assisted in study concept and design, review of drafts and final submission of manuscript.

    • Funding The study was funded by a Self- Initiated Research Grant from the South African Medical ResearchCouncil.

    • Competing interests None declared.

    • Patient consent Parental/guardian consent obtained.

    • Ethics approval The study was approved by the Human Research Ethics Committee of the University of the Witwatersrand.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Data can be made available upon reasonable request to the corresponding author.