Long-term neurocognitive and educational outcomes of neonatal insults in Kilifi, Kenya

• Published in: BMC psychiatry Vol. 20; no. 1; p. 578
• Main Authors: Magai, Dorcas N, Koot, Hans M, Mwangi, Paul, Chongwo, Esther, Newton, Charles R, Abubakar, Amina
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 02.12.2020; BioMed Central; BMC
• Subjects: Age; Aged; Brain damage; Brain diseases; Caregivers; Child; Child & adolescent psychiatry; Children; Children & youth; Cognition; Cognitive ability; Cross-Sectional Studies; Diagnosis; Disability; Educational Status; Encephalopathy; Families & family life; Hospitals; Humans; Hypoxia; Hypoxic-ischemic encephalopathy; Infant, Newborn; Intelligence; Ischemia; Jaundice; Kenya; Low income groups; Memory; Memory, Short-Term; Mental health; Neonatal jaundice; Neonates; Neurocognitive impairment; Newborn babies; Patient outcomes; Pregnancy; Psychiatry; Questionnaires; Short term memory; Survivors; Kenya; Africa; Disability; Neurocognitive impairment; Neonatal jaundice; Children; Hypoxic-ischemic encephalopathy
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-020-02939-9

There is little data on the long-term neurocognitive and educational outcomes among school-aged survivors of neonatal jaundice (NNJ) and hypoxic-ischemic encephalopathy (HIE) in Africa. This study investigates the long-term neurocognitive and educational outcomes and the correlates of these outcomes in school-aged survivors of NNJ or HIE in Kilifi, Kenya. We conducted a cross-sectional study on neurocognitive and educational outcomes among school-aged survivors (6-12 years) of NNJ (n = 134) and HIE (n = 107) and compared them to a community comparison group (n = 134). We assessed nonverbal intelligence, planning, working memory, attention, syntax, pragmatics, word-finding, memory, perceptual-motor, mathematical, and reading abilities. We also collected information on medical history, caregivers' mental health, and family environment. The survivors of NNJ had lower mean total scores in word-finding [F (1, 250) = 3.89, p = 0.050] and memory [F (1, 248) = 6.74, p = 0.010] than the comparison group. The survivors of HIE had lower mean scores in pragmatics [F (1, 230) = 6.61, p = 0.011] and higher scores higher scores in non-verbal reasoning [F (1, 225) =4.10, p = 0.044] than the comparison group. Stunted growth was associated with almost all the outcomes in HIE. Survivors of NNJ and HIE present with impairment in the multiple domains, which need to be taken into consideration in the planning of educational and rehabilitative services.