Abstract
BackgroundSouth Africa presents with high preterm birth (PTB) and low birth weight (LBW) rates (14.17%). Numerous conditions characterised by language impairment are associated with LBW and/or PTB. Speech-language therapists may fail to identify older children whose language impairment may have originated from LBW and/or PTB.ObjectiveTo describe the frequency of LBW and/or PTB, in comparison with full-term birth, and associated conditions in children at an early communication intervention (ECI) clinic.MethodsRetrospective data of 530 children aged 3–74 months were analysed, with 91.9% presenting with language impairment.ResultsAlmost 40% had LBW and/or PTB, and late PTB was the largest category. Factors associated with LBW and/or PTB were prenatal risks, including small-for-gestational age, perinatal risks, including caesarean section, and primary developmental conditions. Secondary language impairment was prevalent, associated with genetic conditions and global developmental delay.ConclusionThe frequency of LBW and/or PTB was unexpectedly high, drawing attention to the origins of language impairment in almost 40% of the caseload at the ECI clinic.
Highlights
As a low-to-middle-income country, South Africa presents with preterm birth (PTB) (< 37 weeks gestational age) and low birth weight (LBW) (< 2500 g) rates as high as 14.17%, as opposed to 7% in high-income countries (Feresu, Harlow, & Woelk, 2015; Howson, Kinney, & Lawn, 2012; Pattinson, 2013)
Children born with Foetal Alcohol Spectrum Disorder (FASD) are small-for-gestational age, which is associated with intrauterine growth restriction and often accompanied by PTB (Peranich, Reynolds, O’Brien, Bosch, & Cranfill, 2010)
The average birth weight for the LBW and/or PTB group was 2303.3 g, which corresponds with infants born late preterm (Stolt et al, 2016), and 3269.3 g for the normal birth weight (NBW) and/or full term (FT) group
Summary
As a low-to-middle-income country, South Africa presents with preterm birth (PTB) (< 37 weeks gestational age) and low birth weight (LBW) (< 2500 g) rates as high as 14.17%, as opposed to 7% in high-income countries (Feresu, Harlow, & Woelk, 2015; Howson, Kinney, & Lawn, 2012; Pattinson, 2013). Severe developmental disabilities associated with LBW and/or PTB include cerebral palsy (CP), sensory impairments of vision and hearing, mental disability and seizure disorder (Allen, 2008; Van de Weijer-Bergsma, Wijnroks, & Jongmans, 2008). These disabilities may all be associated with secondary language impairment. Language impairment in children born preterm and with LBW may co-occur secondary to various genetic syndromes or congenital conditions One of these conditions is Foetal Alcohol Spectrum Disorder (FASD), a congenital disorder affecting 6% of the South African population (Foundation for Alcohol Related Research [FARR], 2016). Speech-language therapists may fail to identify older children whose language impairment may have originated from LBW and/or PTB
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