Retrospective Cohort Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Feb 8, 2017; 6(1): 24-33
Published online Feb 8, 2017. doi: 10.5409/wjcp.v6.i1.24
Language and cognitive outcome for high-risk neonates at the age of 2-3 years - experience from an Arab Country
Tamer Abou-Elsaad, Hesham Abdel-Hady, Hemmat Baz, Doaa ElShabrawi
Tamer Abou-Elsaad, Hemmat Baz, Phoniatric Unit, ORL Department, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
Hesham Abdel-Hady, Neonatal Intensive Care Unit, Mansoura University Children’s Hospital, Mansoura 35516, Egypt
Doaa ElShabrawi, Phoniatric Unit, ORL Department, Mansoura General Hospital, Mansoura 35511, Egypt
Author contributions: Abou-Elsaad T and Abdel-Hady H designed the research, provided the clinical advice and wrote the paper; Baz H supervised the research, contributed to the analysis and wrote the paper; ElShabrawi D conducted the research, contributed to the analysis and wrote the paper.
Institutional review board statement: The study was reviewed and approved by Institutional Review Board of the Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt.
Informed consent statement: All parents/legal guardians provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We (all the authors) declare that we have no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is 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/
Correspondence to: Tamer Abou-Elsaad, MD, Professor of Phoniarics, Head of Phoniatric Unit, ORL Department, Faculty of Medicine, Mansoura University, Gehan str., Mansoura 35516, Egypt. taboelsaad@hotmail.com
Telephone: +20-0100-5192300
Received: June 6, 2016
Peer-review started: June 17, 2016
First decision: July 27, 2016
Revised: September 26, 2016
Accepted: October 25, 2016
Article in press: October 27, 2016
Published online: February 8, 2017
Abstract
AIM

To investigate the effect of different neonatal risk factors on different language parameters as well as cognitive abilities among Arabic speaking Egyptian children at the age of two to three years of life and to find out which risk factor(s) had the greatest impact on language and cognitive abilities.

METHODS

This retrospective cohort study was conducted on 103 children with age range of 2-3 years (median age 31 mo). They were 62 males and 41 females who were exposed to different high-risk factors in the perinatal period, with exclusion of metabolic disorders, sepsis/meningitis, congenital anomalies and chromosomal aberrations. The studied children were subjected to a protocol of language assessment that included history taking, clinical and neurological examination, audiological evaluation, assessment of language using modified preschool language scale-4, IQ and mental age assessment and assessment of social age.

RESULTS

The studied children had a median gestational age of 37 wk, median birth weight of 2.5 kg. The distribution of the high-risk factors in the affected children were prematurity in 25 children, respiratory distress syndrome in 25 children, hypoxic-ischemic encephalopathy in 15 children, hyperbilirubinemia in 10 children, hypoglycemia in 13 children, mixed risk factors in 15 children. The results revealed that high-risk neonatal complications were associated with impairment of different language parameters and cognitive abilities (P < 0.05). The presence of prematurity, in relation to other risk factors, increases the risk of language and cognitive delay significantly by 3.9 fold.

CONCLUSION

Arabic-speaking children aged 2-3 years who were exposed to high-risk conditions in the perinatal period are likely to exhibit delays in the development of language and impairments in cognitive abilities. The most significant risk factor associated with language and cognitive impairments was prematurity.

Keywords: High-risk neonates, Prematurity, Arabic language, Cognition, Child disability

Core tip: The aim of this retrospective cohort study was to evaluate the effect of different neonatal risk factors on different language parameters as well as cognitive abilities among Arabic speaking Egyptian children at the age of two to three years and to find out which risk factor(s) had the greatest impact on language and cognitive abilities. The results revealed that Arabic-speaking children who were exposed to high-risk conditions in the perinatal period are likely to exhibit delays in the development of language and impairments in cognitive abilities. The most significant risk factor associated with language and cognitive impairments was prematurity.