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

Dorcas N Magai,Paul Mwangi,Charles R Newton,Esther Chongwo,Amina Abubakar,Hans M Koot

doi:10.1186/s12888-020-02939-9

Abstract

BackgroundThere 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.MethodsWe 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.ResultsThe 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.ConclusionSurvivors 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.

Highlights

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
Study design This is a cross-sectional study of children aged six to 12 years admitted with NNJ or HIE at Kilifi County Hospital (KCH)
Neurocognitive and educational outcomes in hypoxicischemic encephalopathy In this study we found that survivors of HIE scored poorer on pragmatics but did not differ in planning, visual attention, working memory, memory, syntax, and mathematical and reading skills in comparison with the Nonverbal Planning intelligence

Summary

Introduction

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. Magai et al BMC Psychiatry (2020) 20:578 speech and language deficits later in life have been reported in other studies of survivors of NNJ [19, 24] and survivors of mild and moderate [9, 13, 14], and severe [15,16,17] HIE These studies provide information on the long-term neurocognitive and educational outcomes of school-aged survivors of NNJ or HIE, all the studies are from high-income countries, and little is known about the outcomes of school-aged survivors of NNJ or HIE in low-income settings such as those in sub-Saharan Africa where the incidence of NNJ and HIE is high.

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