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. 2023 May 27;10(6):957.
doi: 10.3390/children10060957.

Neurodevelopmental Outcome at 6 Months Following Neonatal Resuscitation in Rural Tanzania

Ingrid Ask Torvik  1   2 , Robert Moshiro  3 , Hege Ersdal  1   2 , Anita Yeconia  4 , Raphael Mduma  4 , Jeffrey Perlman  5 , Jørgen Linde  2
Affiliations

Neurodevelopmental Outcome at 6 Months Following Neonatal Resuscitation in Rural Tanzania

Ingrid Ask Torvik et al. Children (Basel). .

Abstract

Early bag-mask ventilation (BMV) administered to non-breathing neonates at birth in the presence of birth asphyxia (interruption of placental blood flow) has reduced neonatal mortality by up to 50% in low- and middle-income countries. The neurodevelopmental outcome of neonates receiving BMV remains unknown. Using the Malawi Developmental Assessment Tool (MDAT), infants who received BMV at birth were assessed at 6 months, evaluating gross motor, fine motor, language and social skills. A healthy cohort with no birth complications was assessed with the same tool for comparison. Mean age-adjusted MDAT z-scores were not significantly different between the groups. The number of children having developmental delay defined as a z-score ≤ -2 was significantly higher in the resuscitated cohort for the fine motor and language domain and overall MDAT z-score. The prevalence of clinical seizures post discharge was significantly higher in the resuscitated group and was associated with neurodevelopmental delay. Infants with developmental delay or seizures were more likely to have a 5 min Apgar < 7 and a longer duration of BMV. Most children receiving BMV at birth are developing normally at 6 months. Still, there are some children with impaired development among resuscitated children, representing a subgroup of children who may have suffered more severe asphyxia.

Keywords: bag-mask ventilation; follow up; helping babies breathe; neonatal resuscitation; neurodevelopment.

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Conflict of interest statement

The authors declare no conflict of interest. The funder had no role in the design; data collection, analyses or interpretation; writing or decision to publish the results.

Figures

Figure 1
Figure 1
(a) Resuscitated cohort, (b) healthy cohort. a Refused to participate in study, b terminated: Gender or date of birth did not fit with the research database, or we were not able to assess them within the target window.
Figure 2
Figure 2
Neurodevelopmental outcomes as the distribution of age-adjusted z-scores of the Malawi Developmental Assessment Tool (MDAT) in the resuscitated cohort (a) and healthy cohort (b). The boxplot (c) demonstrates extreme outliers in the resuscitated cohort. Circles (ο) represent potential outliers within 1.5–3 interquartile ranges (IQR) from the quartile 1. Asterix (*) represents extreme outliers that are more than 3 IQR from the quartile 1.
Figure 2
Figure 2
Neurodevelopmental outcomes as the distribution of age-adjusted z-scores of the Malawi Developmental Assessment Tool (MDAT) in the resuscitated cohort (a) and healthy cohort (b). The boxplot (c) demonstrates extreme outliers in the resuscitated cohort. Circles (ο) represent potential outliers within 1.5–3 interquartile ranges (IQR) from the quartile 1. Asterix (*) represents extreme outliers that are more than 3 IQR from the quartile 1.
See this image and copyright information in PMC

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