Original articleNeonatal neurological examination in a resource-limited setting: What defines normal?
Section snippets
Sample
This is a nested substudy of a larger single-center, hospital-based, prospective observational study (IMPRINT: Impact of Malaria in Pregnancy on Infant Neurodevelopment). The IMPRINT study aimed to compare neonatal neurological outcomes of infants exposed to malaria in pregnancy with those of unexposed infants. Participants were recruited from Korle Bu Teaching Hospital in Accra, the largest tertiary teaching hospital in Ghana, with approximately 10,000 live births annually. This hospital is
Ghanaian sample vs. normative data from the United Kingdom
There were no significant differences in maternal demographic characteristics between the infants included in this nested substudy and the remaining infants included in the larger IMPRINT study, though significantly more excluded mothers had a history of a sexually transmitted infection (P < .001). In total, 140 low-risk, term-born neonates (136 Ghanaian, 2 Nigerian, 1 Ivorian, 1 Malian ethnicity) were assessed; 35 neonates were not in the correct state and could not be administered all items,
Discussion
This study described the results of the HNNE in a sample of low-risk, term-born Ghanaian neonates born in a tertiary care referral hospital. Neonates were scored using the HNNE optimality scoring system, published in 1998 and developed using normative data from a sample of 224 neonates born in the United Kingdom. The extent of similarities and differences in the HNNE scores in Ghana and other LMICs were also documented. The profile of HNNE scores of neonates in Ghana and published results from
Funding
This work was supported by a Mater Foundation Principal Research Fellowship to Dr. Samudragupta Bora and The University of Queensland Research Training Program and Frank Clair scholarships to Ms. Harriet L.S. Lawford. The funding sources had no role in the writing of the manuscript or in the decision to submit it for publication.
Financial disclosure
The authors have no financial relationship relevant to this study to disclose.
Declaration of competing interests
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Acknowledgments
Dr. Akomah Kennedy, Dr. Godwin A. Awuni, Dr. Newton E. Ofosu, Dr. Oyeronke S. Oyawoye, Dr. Temitope Akinyemi, Dr. Vida Akrasi-Boateng, and Mr. Hanson G. Nuamah at the University of Ghana for assistance with data collection. Most importantly, we would like to thank the children and their families who participated in the IMPRINT study.
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