High-Risk Factors,Clinical Features And Prognosis Of 185 Cases With Global Developmental Delay

Objective Global development delay,GDD, seriously affects the normal growth and development of children and give a burden to the family and society, but at present there is no complete comprehensive clinical research about it. To discuss the main high-risk factors, clinical features and prognosis of GDD, thus to provide effective basis for reducing incidence of GDD children,early diagnosis,early intervention and improving prognosis.Methods Selecting 185 children with GDD who were diagnosed for the first time and intervened at our center from October 2011 to September 2013, to analyze high-risk factors, clinical features, complication,prognosis and measurement results have been with average±standard deviation. While we made 2 years of follow-up and intervene in all process, using c 2 test to compare high-risk factors and prognosis of different clinical features of children with GDD and Logistic regression model to analyze high-risk factors influencing prognosis.Result In 185 cases of GDD, there were 119(64.3%) children with motor and language developmental delay for the most common, followed were types of motor combined cognitive and language developmental delay making up 30 cases(16.2%) and cognitive merged language developmental delay taking up 22 cases(11.9%) and the least type of 14 cases(7.6%) was motor and cognitive developmental delay. Age of children diagnosed GDD for the first time was 9 to 48 month and it was mainly at 10-16 months, the age distribution was more dispersed after 16 month. The main high-risk factors were 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.; the most common complication were epilepsy and hearing disorders and the incidence of them is significantly higher than normal children.2 years of follow-up ending, 40 cases(21.6%)turned to be of normal and most is the type of motor and language development delay;but 145children(78.4%)were still abnormal,including 97 children(52.5%)having significantly improved after the intervention,30 cases(16.2%)of intellectual disability,ID, which main were children of motor combined cognitive developmental delay and 18 cases of cerebral palsy while most were motor and language development delay; the difference of various clinical features was statistically significant( c 2=60.960,P=0.017<0.05); multivariate Logistic regression model analysis showed that he main high-risk factors affecting prognosis were intrauterine growth retardation( β =0.777,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. The main high-risk factors hindered the normal development of children are intrauterine growth retardation、intrauterine hypoxia, HIE and neonatal asphyxia and we should prevent the happen of neonatal asphyxia, premature birth, pathologic jaundice, intrauterine growth retardation, intrauterine hypoxia, neonatal hypoxic-ischemic encephalopathy(HIE),neonatal infection and pregnancy-induced hypertension syndrome and other high-risk factors, especially). For GDD with high-risk factors, we should observe their motor,language, cognitive and other development to find abnormalities early. It is important to reduce the incidence of GDD and improve prognosis to early diagnose and early intervene.