Language Exposure in the Neonatology Ward as a Modifiable Determinant of

Neurodevelopmental Outcomes in Preterm Infants

Chapter I
The Problem and its Background

Introduction
You don't choose your family, they are Gods gift to you as you are to them. Babies are Gods

gift to people. They bring joy and happiness in this world. These are saying pertaining to how the
world perceived the babies. Unfortunately, there are several newborn that have neurodevelopmental
delay. There are number of factors that can be attributed to these delay and one of which those that
are born preterm.
Preterm as defined by the World Health Organization as babies born alive before 37 week of
pregnancy are completed. There are numerous problem associated with babies that are born preterm
and one of which is Neurodevelopment delay.
According to the World Health Organization 60% of preterm occurs in Africa and South Asia.
Philippines ranked 8th in cases with the most number of preterm births with 348,900.
National Childrens Hospital catered children ages 0-19 years of age including preterm babies.
Preterm infants admitted at Neonatology Ward experience neurodevelopment delay and it is believe
that Language exposure help for these preterm babies to cope with this delay hence the
conceptualization of this research is made.

Background of the Problem

An estimated 15 million babies are born too early every year. That is more than 1 in 10
babies. Almost 1 million children die each year due to complications of preterm birth. Many
survivors face a lifetime of disability, including learning disabilities and visual and hearing
problems.
Globally, prematurity is the leading cause of death in children under the age of 5. And in
almost all countries with reliable data, preterm birth rates are increasing.
Inequalities in survival rates around the world are stark. In low-income settings, half of the
babies born at or below 32 weeks (2 months early) die due to a lack of feasible, cost-effective
care, such as warmth, breastfeeding support, and basic care for infections and breathing
difficulties. In high-income countries, almost all of these babies survive.
More than 60% of preterm births occur in Africa and South Asia, but preterm birth is truly a
global problem. In the lower-income countries, on average, 12% of babies are born too early
compared with 9% in higher-income countries. Within countries, poorer families are at higher
risk.

All over the world, preterm birth is a major cause of death and important neurodevelopmental
disorders. Approximately 9.6% (12.9 million) births worldwide are preterm.

Conceptual Framework

Preterm
infants

Neurodevelopmental
delay

Language Exposure

Outcome

Research Paradigm

Preterm
infants

Neurodevelopmental
delay

Language Exposure

Outcome

Statement of the Problem

Preterm infant are affected by having neurodevelopmental delay if taken for granted.

Research Hypotheses

Language Exposure affects positively with regards to the neurodevelopmental aspects of

preterm infants.

Significance of the Study

This study will alleviate the neurodevelopmental delay among preterm infants using Language
exposure as a modifiable determinant

Scope and Delimitation

This study will be conducted at National Childrens Hospital Neonatology Ward and participants
will be those preterm infant with consent and participation of the mother. This study will be
limited to the patients in Neonatology Ward.

Definition of Terms

Preterm- infant born less than 37 weeks of gestations

Local Literature

Chapter II
Review of Related Literature and Studies

Preterm birth is the worlds largest killer of babies, causing more than 1 million deaths each
year worldwide, yet 75 per cent could be saved without high technology care. The Philippines
ranks 8th out of 184 countries for the number of babies born prematurely, and ranks 17th for the
total number of deaths due to complications from preterm birth.
Kangaroo Mother Care is a technique wherein he tiny infant is placed skin-to-skin upright
between the mothers breasts and then tied to the mothers chest with a cloth. This keeps the
preterm baby warm and facilitates breastfeeding. Keeping preterm babies warm is especially
important because their tiny bodies lose heat rapidly, making them highly vulnerable to illness,
infection and even death. It is also important for the mother to talked to their babies to stimulate
development of hearing and language.

Foreign Literature

15 million babies are born too soon every year. More than 1 in 10 babies are born preterm,
affecting families all around the world. Over 1 million children die each year due to
complications of preterm birth. Many survivors face a lifetime of disability, including learning
disabilities and visual and hearing problems.
The implications of being born too soon extend beyond the neonatal period and throughout
the life cycle. Babies who are born before they are physically ready to face the world often
require special care and face greater risks of serious health problems, including cerebral palsy,
intellectual impairment, chronic lung disease, and vision and hearing loss. This added dimension

of lifelong disability exacts a high toll on individuals born preterm, their families and the
communities in which they live (Institute of Medicine, 2007)

Local Studies

Foreign Studies

Preterm birth is the leading cause of newborn deaths in the United States. Being born too early is
not just detrimental to a babys survival outside of the womb. It can also lead to health
complications in the child including mental retardation, blindness, deafness, neurological and
behavioral problems. It is also now known that it makes them more prone to diabetes and
cardiovascular diseases as adults.
Nearly 12 percent (11.7 percent) of women of Filipino descent in Hawaii deliver their babies early
compared to either white (7.2 percent) or other Asian populations (9 percent) in the state. The
normal length of pregnancy is 40 weeks and the study focused on late preterm birth (34 weeks to 36
weeks and 6 days).
The new research featured as the cover story in Septembers American Journal of Obstetrics and
Gynecology, found an association between a genetic variant in the DNA of Filipino women and
higher levels of a hormone that increases the chances of preterm birth.

Relevance to the Present Study

This study will alleviate the delay in the neurodevelopment aspect of preterm infant through

language exposure.

Chapter III
Research Design
Population, Sample and Sampling Technique
Research Instrument
Data Gathering Procedure
Statistical Treatment of Data