High-risk factors, clinical features and prognosis of children with global developmental delay / 中华实用儿科临床杂志

ABSTRACT

Objective To discuss the main high-risk factors,clinical features and prognosis of global developmental delay(GDD),so as to provide effective basis for reducing incidence of children with GDD,early diagnosis,early intervention and improving prognosis.Methods One hundred and eighty-five cases of children with GDD,who were first diagnosed and treated in the Pediatric Neurology Rehabilitation Center,the First Affiliated Hospital of Anhui Medical University from October 2011 to September 2013,were included and high-risk factors,clinical features,and prognosis were analyzed.At the same time,the patients were followed up for 2 years and the children with abnormal development received continuous intervention and treatment during the follow-up.x2 test was used to compare high-risk factors and prognosis of different clinical features and Logistic regression models were selected to analyze high-risk factors influencing prognosis.Results In 185 cases with GDD,there were 119 children (64.3％) with motor and language developmental delay,which were the most common features,and followed by types of motor combined cognitive and language developmental delay which make up 30 cases (16.2％) and cognitive merged language developmental delay which make up 22 cases (11.9％) and the rarest type of 14 cases (7.6％) was motor and cognitive developmental delay.The main high-risk factors included neonatal asphyxia,premature birth,pathologic jaundice,intrauterine growth retardation,intrauterine hypoxia,neonatal hypoxic-ischemic encephalopathy (HIE),neonatal infection and pregnancy-induced hypertension syndrome and the differences of various clinical features with premature birth,intrauterine growth retardation,pathologic jaundice were statistically significant.Up to 2 years of follow-up,40 cases (21.6％) turned normal,but 145 children (78.4％) were still abnormal,including 97 children (52.5％) having significantly improved after intervention,30 cases(16.2％)of intellectual developmental disorder and 18 cases (9.7％) of cerebral palsy.The differences in various clinical features showed statistically significance (x2=60.960,P=0.017).The main high-risk factors affecting prognosis were intrauterine growth retardation [β=0.777,odds ratio (OR)=2.174],intrauterine hypoxia (β=0.706,OR=2.026),HIE(β=0.547,OR=1.729) and neonatal asphyxia (β=0.070,OR =1.073).Conclusion Causes of GDD are complex and prognosis is poor and the etiology and prognosis of children with different clinical features are also different.It is important to enhance perinatal care,early diagnosis and intervention for reducing the incidence of GDD and improving prognosis.