Project Details

Maternal, perinatal, and neonatal risks for neurodevelopmental impairment in a Zimbabwean cohort

Faith Goronga, MD, MPH, MS

Summary

BACKGROUND: Maternal, perinatal, and neonatal risk factors for neurodevelopmental impairment and developmental delay (NDI/DD) have not been well-described in low-and middle- income countries (LMIC), and identification of such risk factors would provide an opportunity to target interventions and programming to reduce the burden of NDI/DD in countries like Zimbabwe. GAP: There is a paucity of epidemiological data in LMIC describing risks factors for NDI/DD in the antenatal, perinatal and post-natal period, this study will contribute important data that can be used to aid in early identification of neonates at risk NDI/DD in a low resource setting. HYPOTHESIS: 1) Hypothesis 1: Maternal risk factors for NDI/DD between 18 and 26 months of age will include pre-eclampsia, gestational diabetes, HIV infection, COVID-19 infection/symptoms, smoking/alcohol/drug use in pregnancy. 2) Hypothesis 2: In addition to previously described perinatal and neonatal risk factors (low birthweight, perinatal asphyxia, low Apgar scores and NICU admission), additional risk factors for NDI/DD between 18 and 26 months of age include poor feeding, medication administration in the NICU, and respiratory support in the first month of life. METHODS: This is a prospective cohort study that will utilize an existing cohort of mother-infant dyads to assess risk factors for NDI/DD identified at an in-person follow-up visit utilizing the Griffiths Scales of Child Development, 3rd Edition (Griffiths III) with 18- and 26-month-olds. RESULTS: Pending. IMPACT: This population-representative cohort provides an opportunity to identify as yet unknown or unaddressed context-specific maternal, perinatal and neonatal risks for NDI/DD, and quantify the relative impact of these risks in this low-resource setting. This will help identify factors with greatest need for intervention to attenuate the burden of NDI/DD in this setting and help direct future research.