Abstract

ABSTRACT:
BACKGROUND:
There are wide ranges of causes behind global developmental delay in Iraqi children but most of these
causes were not diagnosed as a result of unavailable diagnostic tools.
OBJECTIVE:
To study the etiology of global developmental delay in Children Welfare Teaching Hospital / Baghdad.
PATIENTS AND METHODS:
A descriptive study was done on 75 patients, their age range from 8 months to 5.5 years with global
developmental delay, who consult Children Welfare Teaching Hospital/Baghdad, from 1
of May 2010
to 1
st
of October 2010. A full history, thorough physical examination, and developmental assessment
according to Denver Developmental Scale II were done to all cases. A group of selected investigations
including neuroimaging (CT & MRI), EMG, EEG, visual and hearing assessment, screen for metabolic
diseases, and thyroid function test were done as needed for the diagnosis.
RESULTS:
A total of 75(preschool) patients with age range from 8 months to 5.5 years were studied; 45(60%) of
them were males and 30(40%) were females,9(12%) were preterm, 26(34.6%) were born with LBW,
3(4%) of patients acquired the infection with TORCH from their mothers [2(2.7%)CMV,
1(1.3%)toxoplasmosis], 8(10.7%) had their mothers complained from chronic diseases (hypertension
and diabetes mellitus ), 11(14.7%) suffered birth asphyxia, 2(2.7%) with high bilirubin level exceeding
20mg/dl, 2(2.7%) patients suffered RDS and 1(1.3%) suffered sepsis diagnosed by blood culture during
neonatal period .Family history of developmental delay was reported in 11(14.7%) and consanguinity
was reported in 46(61.3%) of cases, in 33(43.9%) no cause could be identified, CNS infections 9(12%),
Down syndrome 7(9.3%), hypothyroidism 2(2.7%), intracranial hemorrhage 2(2.7%), infantile spasm
2(2.7%), phenylketonuria 2(2.7%), Myotonia Dystrophica 1(1.3%), and Seckel syndrome 1(1.3%).
CONCLUSION:
Global developmental delay in pediatric practice has wide etiology. The majority of cases were not
diagnosed because of deficient diagnostic tools like cytogenetic analysis. High percent of perinatal
etiology raises the importance of good maternal and neonatal care. Under diagnosis of inborn error of
metabolism due to lack of routine screening in neonatal period, aggravated the problem