DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20201131

Follow up of growth, development and clinical outcome in neonates discharged from the NICU of tertiary care hospital in central India

Prithvichandra K. C., Pawan K. Ghanghoriya

Abstract


Background: To assess the growth and neurodevelopmental outcome of all newborn discharged from the NICU of Netaji Subhash Chandra Bose Medical College, Jabalpur on follow up for 6 months.

Methods: Prospective observational cohort study of 200 high risk newborn discharged from NICU. Babies were called for follow up at 1 month, 2 months, 4 month and 6 months of corrected age and detailed information was taken regarding NICU stay and morbidity with the help of data available from discharge card. Anthropometric parameters like weight, length, and head circumference were noted.  Suitable screening tests like denver’s developmental screening test for Indian infants (DDSTII) for NDD (neurodevelopmental delay) and Amiel Tison scoring for tone assessment was done.

Results: Among the 200 NICU graduates chosen, 40 lost during follow up. The neurodevelopmental delay in this study was 31.3%. Authors also analysed NDD according to gestational age wise groups. NDD in pre-terms was 39.6%. The developmental delay was more in babies with neonatal sepsis, perinatal asphyxia, prematurity, RDS, NEC etc.

Conclusions: The morbidities like severe perinatal asphyxia, hypoglycaemia, seizures, shock, hypoxia, hypothermia, low gestational age have direct association with NDD.


Keywords


Amiel Tison score, Denvers developmental screening test for Indian infants, Neuro developmental delay, Neonatal intensive care unit, Respiratory distress syndrome, Necrotizing enterocolitis

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References


Narayan S, Aggarwal R, Upadhyay A, Deorari AK, Singh M, Paul VK. Survival and morbidity in extremely low birth weight (ELBW) infants. Ind Pediatr. 2003 Feb;40(2):130-4.

Wilson-Costello D, Friedman H, Minich N, Siner B, Taylor G, Schluchter M, et al. Improved neurodevelopmental outcomes for extremely low birth weight infants in 2000-2002. Pediatrics. 2007 Jan 1;119(1):37-45.

Escobar GJ, Littenberg B, Petitti DB. Outcome among surviving very low birthweight infants: a meta-analysis. Archiv Dis Childhood. 1991 Feb 1;66(2):204-11.

Hintz SR, Poole WK, Wright LL, Fanaroff AA, Kendrick DE, Laptook AR, et al. Changes in mortality and morbidities among infants born at less than 25 weeks during the post-surfactant era. Archiv Dis Childhood-Fetal Neon Ed. 2005 Mar 1;90(2):F128-33.

Chaudhari S. Learning problems in children who were "high-risk" at birth. Ind Pediatr. 1994; 31:1461-64.

Denver Developmental materials.Inc. Denver II online.2015. Available at: http;//denverii.com/denverii/index.php?route=information/information&information_id=14. Accessed June 2015.

Illingworth RS. The development of the infant and the young child: Normal and abnormal. Elsevier Health Sci. 2013 Apr 4:236.

Chattopadhyay N, Mitra K. Neurodevelopmental outcome of high risk newborns discharged from special care baby units in a rural district in India. J Pub Health Res. 2015 Feb 20;4(1):318.

Modi R, Patel J, Mishra A. Neurodevelopmental outcome of high-risk newborns discharged from NICU in a tertiary-care hospital of western India. Inter J Med Sci Pub Health. 2016 Jul 1;5(07):1350.

Singh D, Devi N, Raman TR. Exclusive breast feeding in low birth weight babies. Med J Armed Forces Ind. 2009 Jul 1;65(3):208-12.

Xiong T, Gonzalez F, Mu DZ. An overview of risk factors for poor neurodevelopmental outcome associated with prematurity. World J Pediatr. 2012 Nov 1;8(4):293-300.

Mukhyopadhyay K, Malhi P. Neurodevelopmental and behavioural outcome of very low birth weight babies at corrected age of 2 years. Ind J Pediatr. 2010;77:963-7.

Sudhir U, Ghanghoriya. P. Growth and neurodevelopmental outcome of high-risk premature neonates at 1 year in a tertiary level NICU of central India. Int J Contemp Pediatr. 2017 sep:4(5):1787-91.

Stoll BJ, Hansen NI, Adams-Chapman I, Fanaroff AA, Hintz SR, Vohr B, et al. Neurodevelopmental and growth impairment among extremely low-birth-weight infants with neonatal infection. JAMA. 2004 Nov 17;292(19):2357-65.

Carli G, Reiger I, Evans N. One‐year neurodevelopmental outcome after moderate newborn hypoxic ischaemic encephalopathy. J Paediatr Child Health. 2004 Apr;40(4):217-20.

Kumar KS, Nazeer S. Neurodevelopmental outcome of babies with hypoxic ischaemic encephalopathy. Inter J Res Med Sci. 2017:3197-203.

Baburaj S, Abraham B, Vasant P, Raj S, Mohandas MK. Growth and development of high-risk graduates till one year from a rural neonatal intensive care unit in south India. Intern J Biomed Res. 2013;4(12):695-700.

Padayachee N, Ballot DE. Outcomes of neonates with perinatal asphyxia at a tertiary academic hospital in Johannesburg, South Africa. South Afric J Child Health. 2013;7(3):89-94.

Melana N, Ahmed N, Soni RK, Goyal M. Neurodevelopmental Outcome in Neonates with Hypoglycaemia and Associated Risk Factors: A Follow up Study. J Preg Child Health. 017;4:323.

Rees CM, Pierro A, Eaton S. Neurodevelopmental outcomes of neonates with medically and surgically treated necrotizing enterocolitis. Archiv Dis Childhood-Fetal Neonatal Ed. 2007 May 1;92(3):F193-8.

Babu A, Bhat V. Predictors of abnormal neurodevelopment at 6 months in term babies with early neonatal hyperbilirubinemia. A prospective cohort study from South India. Birth. 2011 Jul 1;34(21):82-95.