Tskimanauri N, Khachapuridze N, Imnadze P, Chanadiri T, Bakhtadze S
Tbilisi State Medical University; Neurological Clinic LTD "Valeo", Tbilisi; ³I. Javakhishvili Tbilisi State University, Georgia.
Georgian Med News. 2018 Jun(279):56-61.
The purpose of this research was to investigate the developmental follow-up of children of 24 months age, exposed to separate and combination impact of perinatal risk factors, compared with not exposed cases, within the prospective cohort study. Between January 2017 and January 2018, was conducted final stage of research, where were participated the medical centers in Tbilisi (capital of Republic of Georgia) and Mtskheta, Dusheti (districts of Georgia). Within postnatal follow-up, the children from whole population were assessed at 24 month of age by family doctors using the Denver Developmental Screening Test (Denver II). The association between the risk factors and neurodevelopmental outcomes was analyzed by Chi-square test of independence. Statistical analysis of these data was performed using the SPSS version 12.0.1 (SPSS Inc., Chicago, IL). A P value of less than 0.01 was considered as significant. Prevalence of abnormal development in whole population was revealed 2.9% or 30 cases at age of 24 month. Statistical analysis showed that an abnormal developmental outcomes were more frequent when researched risk factors, such as maternal age <17>35YY (OR-22.17, CI 95% - 8.91 to 55.15), pathologies of pregnancy (OR-13.79 CI 95% - 6.19 to30.71) and/or delivery (OR -7.74 CI 95% - 3.69 to 16.26), birth before 37 weeks of gestation (OR-29.30 CI 95% - 13.29 to 64.61), were exposed as well, as correlation of these risk factors with neurodevelopmental adverse outcomes was significant (p<0.0001). Neonatal pathologies, such as gestation age, neonatal sepsis with complication and combination with other risk factors and CNS malformation, combined with some perinatal risk factors were correlated strongly with adverse neurological disorders (p<0.0001) at age of 24 month. There was less significant correlation between Hypoxic-ischemic encephalopathy I-II stage of severity, as well as intracranial hemorrhage of I-II stages and neurodevelopmental outcomes (p<0.05). The most significant single risk factor for abnormal neurodevelopmental outcome was gestation age, maternal age and pathologies of pregnancy. High frequency of neurodevelopmental adverse outcomes were correlated with combined impact of risk factors and neonatal disorders, especially neonatal sepsis with complication and CNS malformation.
