{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:37:26Z","timestamp":1787027846265,"version":"build-2736575974"},"reference-count":32,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,5,27]],"date-time":"2023-05-27T00:00:00Z","timestamp":1685145600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Laerdal Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Early bag-mask ventilation (BMV) administered to non-breathing neonates at birth in the presence of birth asphyxia (interruption of placental blood flow) has reduced neonatal mortality by up to 50% in low- and middle-income countries. The neurodevelopmental outcome of neonates receiving BMV remains unknown. Using the Malawi Developmental Assessment Tool (MDAT), infants who received BMV at birth were assessed at 6 months, evaluating gross motor, fine motor, language and social skills. A healthy cohort with no birth complications was assessed with the same tool for comparison. Mean age-adjusted MDAT z-scores were not significantly different between the groups. The number of children having developmental delay defined as a z-score \u2264 \u22122 was significantly higher in the resuscitated cohort for the fine motor and language domain and overall MDAT z-score. The prevalence of clinical seizures post discharge was significantly higher in the resuscitated group and was associated with neurodevelopmental delay. Infants with developmental delay or seizures were more likely to have a 5 min Apgar &lt; 7 and a longer duration of BMV. Most children receiving BMV at birth are developing normally at 6 months. Still, there are some children with impaired development among resuscitated children, representing a subgroup of children who may have suffered more severe asphyxia.<\/jats:p>","DOI":"10.3390\/children10060957","type":"journal-article","created":{"date-parts":[[2023,5,27]],"date-time":"2023-05-27T16:19:37Z","timestamp":1685204377000},"page":"957","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Neurodevelopmental Outcome at 6 Months Following Neonatal Resuscitation in Rural Tanzania"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6781-2722","authenticated-orcid":false,"given":"Ingrid Ask","family":"Torvik","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, Stavanger University, 4036 Stavanger, Norway"},{"name":"Stavanger University Hospital, 4068 Stavanger, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Moshiro","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Muhimbili National Hospital, Dar es Salaam 65000, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hege","family":"Ersdal","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Stavanger University, 4036 Stavanger, Norway"},{"name":"Stavanger University Hospital, 4068 Stavanger, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Yeconia","sequence":"additional","affiliation":[{"name":"Research Center, Haydom Lutheran Hospital, Haydom P.O. Box 9000, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael","family":"Mduma","sequence":"additional","affiliation":[{"name":"Research Center, Haydom Lutheran Hospital, Haydom P.O. Box 9000, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Perlman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Weill Cornell Medical College, New York, NY 10065, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f8rgen","family":"Linde","sequence":"additional","affiliation":[{"name":"Stavanger University Hospital, 4068 Stavanger, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1038\/pr.2013.203","article-title":"Estimates of Neonatal Morbidities and Disabilities at Regional and Global Levels for 2010: Introduction, Methods Overview, and Relevant Findings from the Global Burden of Disease Study","volume":"74","author":"Blencowe","year":"2013","journal-title":"Pediatr. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1177\/08830738010160110201","article-title":"Long-Term Developmental Outcome of Asphyxiated Term Neonates","volume":"16","author":"Dilenge","year":"2001","journal-title":"J. Child Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"F257","DOI":"10.1136\/adc.2003.047985","article-title":"Prevalence, Causes, and Outcome at 2 Years of Age of Newborn Encephalopathy: Population Based Study","volume":"90","author":"Pierrat","year":"2005","journal-title":"Arch. Dis. Child.-Fetal Neonatal Ed."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Namazzi, G., Hildenwall, H., Mubiri, P., Hanson, C., Nalwadda, C., Nampijja, M., Kakooza-Mwesige, A., Waiswa, P., and Tumwine, J.K. (2019). Prevalence and Associated Factors of Neurodevelopmental Disability among Infants in Eastern Uganda: A Population Based Study. BMC Pediatr., 19.","DOI":"10.1186\/s12887-019-1769-z"},{"key":"ref_5","unstructured":"WHO (2012). Guidelines on Basic Newborn Resuscitation, World Health Organization."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1016\/j.resuscitation.2011.12.011","article-title":"Early Initiation of Basic Resuscitation Interventions Including Face Mask Ventilation May Reduce Birth Asphyxia Related Mortality in Low-Income Countries","volume":"83","author":"Ersdal","year":"2012","journal-title":"Resuscitation"},{"key":"ref_7","unstructured":"Dawes, G.S. (1968). Foetal and Neonatal Physiology, Year Book Medical Publishers."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Moshiro, R., Perlman, J.M., Kidanto, H., Kvaloy, J.T., Mdoe, P., and Ersdal, H.L. (2018). Predictors of Death Including Quality of Positive Pressure Ventilation during Newborn Resuscitation and the Relationship to Outcome at Seven Days in a Rural Tanzanian Hospital. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0204084"},{"key":"ref_9","unstructured":"Pediatrics, A.A. (2023, March 24). Helping Babies Breathe 2nd Edition Guideline. Available online: https:\/\/www.aap.org\/en\/aap-global\/helping-babies-survive\/our-programs\/helping-babies-breathe\/helping-babies-breathe-2nd-edition\/."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e353","DOI":"10.1542\/peds.2012-1795","article-title":"Newborn Mortality and Fresh Stillbirth Rates in Tanzania after Helping Babies Breathe Training","volume":"131","author":"Msemo","year":"2013","journal-title":"Pediatrics"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"S47","DOI":"10.1016\/j.ijgo.2009.07.013","article-title":"Neonatal Resuscitation in Low-Resource Settings: What, Who, and How to Overcome Challenges to Scale Up?","volume":"107","author":"Wall","year":"2009","journal-title":"Int. J. Gynaecol. Obstet."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.earlhumdev.2018.02.007","article-title":"Mild Hypoxic Ischaemic Encephalopathy and Long Term Neurodevelopmental Outcome\u2014A Systematic Review","volume":"120","author":"Conway","year":"2018","journal-title":"Early Hum. Dev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/S0140-6736(11)61577-8","article-title":"Long-Term Neurodevelopmental Outcomes after Intrauterine and Neonatal Insults: A Systematic Review","volume":"379","author":"Mwaniki","year":"2012","journal-title":"Lancet"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1038\/pr.2013.206","article-title":"Intrapartum-Related Neonatal Encephalopathy Incidence and Impairment at Regional and Global Levels for 2010 with Trends from 1990","volume":"74","author":"Lee","year":"2013","journal-title":"Pediatr. Res."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Huebner, G., Boothby, N., Aber, J.L., Darmstadt, G.L., Diaz, A., Masten, A.S., Yoshikawa, H., Redlener, I., Emmel, A., and Pitt, M. (2016). Beyond Survival: The Case for Investing in Young Children Globally. NAM Perspect.","DOI":"10.31478\/201606b"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.earlhumdev.2014.04.013","article-title":"Developmental Trajectories of Children with Birth Asphyxia through 36 Months of Age in Low\/Low-Middle Income Countries","volume":"90","author":"Wallander","year":"2014","journal-title":"Early Hum. Dev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.eclinm.2018.12.001","article-title":"Early Childhood Outcomes After Neonatal Encephalopathy in Uganda: A Cohort Study","volume":"6","author":"Tann","year":"2018","journal-title":"EClinicalMedicine"},{"key":"ref_18","unstructured":"(2022, November 29). Haydom Luteran Hospital. Available online: https:\/\/haydom.or.tz\/."},{"key":"ref_19","unstructured":"(2023, April 12). Safer Births. Available online: www.saferbirths.com."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Gladstone, M., Lancaster, G.A., Umar, E., Nyirenda, M., Kayira, E., van den Broek, N.R., and Smyth, R.L. (2010). The Malawi Developmental Assessment Tool (MDAT): The Creation, Validation, and Reliability of a Tool to Assess Child Development in Rural African Settings. PLoS Med., 7.","DOI":"10.1371\/journal.pmed.1000273"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"441","DOI":"10.4269\/ajtmh.21-0596","article-title":"Cognitive Outcomes at 18 Months: Findings from the Early Life Interventions for Childhood Growth and Development in Tanzania (ELICIT) Trial","volume":"106","author":"Parpia","year":"2022","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_22","unstructured":"(2022, June 24). MDAT Scoring Application v1.1. Available online: https:\/\/kieran-bromley.shinyapps.io\/mdat_scoring_shiny\/."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1111\/j.1651-2227.2006.tb02378.x","article-title":"WHO Child Growth Standards Based on Length\/Height, Weight and Age","volume":"95","author":"Group","year":"2006","journal-title":"Acta Paediatr."},{"key":"ref_24","unstructured":"(2022, November 02). WHO Child Growth Standards. Available online: https:\/\/www.who.int\/tools\/child-growth-standards\/software."},{"key":"ref_25","unstructured":"Rosner, B. (2011). Fundamentals of Biostatistics, Brooks\/Cole. [7th ed.]."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.braindev.2016.09.005","article-title":"Neurodevelopmental Outcome of Term Infants with Perinatal Asphyxia with Hypoxic Ischemic Encephalopathy Stage II","volume":"39","author":"Adhikari","year":"2017","journal-title":"Brain Dev."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1179\/2046905515Y.0000000043","article-title":"Long-Term Neurodevelopmental Outcome in High-Risk Newborns in Resource-Limited Settings: A Systematic Review of the Literature","volume":"35","author":"Milner","year":"2015","journal-title":"Paediatr. Int. Child Health"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1016\/S0140-6736(09)60244-0","article-title":"Resuscitation at Birth and Cognition at 8 Years of Age: A Cohort Study","volume":"373","author":"Odd","year":"2009","journal-title":"Lancet"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1111\/jcpp.12247","article-title":"Development of Children at Risk for Adverse Outcomes Participating in Early Intervention in Developing Countries: A Randomized Controlled Trial","volume":"55","author":"Wallander","year":"2014","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/j.jpeds.2012.09.052","article-title":"Randomized Trial of Early Developmental Intervention on Outcomes in Children after Birth Asphyxia in Developing Countries","volume":"162","author":"Carlo","year":"2013","journal-title":"J. Pediatr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.seizure.2019.12.020","article-title":"Incidence of Early-Onset Epilepsy: A Prospective Population-Based Study","volume":"75","author":"Hunter","year":"2020","journal-title":"Seizure"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Ayebare, E., Hanson, C., Nankunda, J., Hjelmstedt, A., Nantanda, R., Jonas, W., Tumwine, J.K., and Ndeezi, G. (2022). Factors Associated with Birth Asphyxia among Term Singleton Births at Two Referral Hospitals in Northern Uganda: A Cross Sectional Study. 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