Perinatal and neonatal risk factors for neurodevelopmental outcome in infants in Karaj.

BACKGROUND Although it is well-known that the incidence of developmental delay in high-risk infants is higher than in low-risk ones, little is known about the risk factors among Iranian infants. The objective of this study was to determine the various pre-, peri-, and neonatal factors in developmental delay in participants and to compare the incidence of each factor with that of the normal population. METHODS The Infant Neurological International Battery developmental assessment was employed as the diagnostic tool by a team of experts. Neurological examinations were performed and a questionnaire was completed as well. The subjects consisted of 6,150 infants divided into two groups respectively, with normal and abnormal scores for the evaluation over a period of 12 months in city of Karaj (Tehran Province). RESULTS The mean age of the participants was 39 weeks. Factors associated with a significant increased risk of developmental delay in the studied population included postneonatal seizures (OR=5.54, 95%CI: 3.1 - 9.6), neonatal seizures (OR=4.37, 95%CI: 1.7 - 10.8), preterm delivery (OR=2.52, 95%CI: 1.3 - 4.7), and type II pneumonia (OR=2.39, 95%CI: 1.4 - 3.8). CONCLUSION To increase the survival rate of neonates and effectiveness of early intervention, the above-mentioned risk factors could be considered as valuable clues. Routine neurodevelopmental screening for neonates and infants for early detection of neurodevelopmental delays is highly recommended. If economic limitations prevent mass-screening of neonates, at least high-risk infants should be routinely re-evaluated.