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Neurodevelopmental outcome of high-risk newborns discharged from NICU in a tertiary-care hospital of western India

Rohit Modi, Jaiminkumar Patel, Apupa Mishra.

Abstract
Background: High-risk newborns are most susceptible to acquire neurodevelopmental delay (NDD). Prior finding of delay in this group and identification of related perinatal factors and their inhibition can avoid incapacity in future life.

Objective: To assess the level of NDD using standard scale and establish an association between the risk factors and level of developmental delay.

Materials and Methods: This prospective, observational study was conducted at neonatal intensive care unit (NICU) of a tertiary-care hospital in Ahmedabad city, Gujarat, India. Hospital-based tracking and neurodevelopmental screening of high-risk newborns discharged between January 2010 and June 2012 from a NICU of teaching hospital was carried out. It was conducted by a team of developmental specialists, using standardized tools such as Denver Developmental Screening Tool II and Trivandrum Developmental Screening Chart. Associated perinatal factors were identified. Early intervention was initiated on those detected with NDD.

Result: Developmental delay was detected in 50% of study population. Of the 25 with developmental delay, 16 were preterm, 12 low birth weight (LBW), with history of sepsis in 24, birth asphyxia in 8, and jaundice in 24 neonates. Prevalence of NDD was significantly higher in babies of LBW, preterm babies, and in babies with history of asphyxia at birth.

Conclusion: Incidence of NDD among high-risk newborns is significantly high, with LBW, prematurity, and birth asphyxia being major contributors. Most NDDs go undetected in the early years of life. Improved perinatal care, early detection, and early intervention at the grass-root level will bring down incidence of developmental challenges in this vulnerable group.

Key words: High-risk newborn, developmental delay, early detection of delay



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