Pattern of growth and neurodevelopmental outcome of preterm babies born ≤34 weeks of gestation in a South Indian tertiary care hospital
DOI:
https://doi.org/10.18203/2349-3291.ijcp20180537Keywords:
Bayley scales of infant and toddler development III, Growth, Hearing impairment, Neurodevelopment, Preterm, Retinopathy of prematurityAbstract
Background: Advances in neonatal care since the early days have led to an increase of survival in preterm infants. Developmental sequelae, however are still a major problem mostly because babies who would previously have been expected to die are now surviving due to neonatal intensive care. There is scarcity of data regarding the outcome of prematurity from low and middle-income countries like India in literature.
Methods: 140 preterm babies born at or before 34 weeks of gestation were enrolled and followed up for 1 year. All babies were screened for retinopathy of prematurity and hearing impairment. Anthropometric measurements were taken at 40 weeks, 3 months, 6 months, 9 months and 12 months of corrected age. Neurodevelopmental assessment was done using the Bayley scales of infant and toddler development III at 1 year of age.
Results: Among 140 preterm babies, 6 babies expired before 1 year. Majority had catch up growth by 1 year of age. Growth and neurodevelopment were inversely proportional to birth weight and gestational age. Incidence of severe ROP requiring intervention was 8.6% and hearing aid was needed in 4%. At 1 year 24% had cognitive delay, 27% had language delay and 29% had motor delay. Intraventricular hemorrhage, culture proven sepsis, shock and DIC in newborn period were strong predictors of neurodevelopmental impairment.
Conclusions: Majority of preterm babies showed catch up growth and had good neuro developmental outcome at 1 year of corrected age.
References
Ehrenkranz R, Dusick A, Vohr B, Wright L. Growth in the neonatal intensive care unit influences neurodevelopmental and growth outcomes of extremely low birth weight infants. Pediatr. 2006;117(4):1253-61.
Stephens BE, Vohr BR. Neurodevelopmental outcome of the premature infant. Pediatric Clin. 2009;56(3):631-46.
Zeitlin J, Szamotulska K, Drewniak N, Mohangoo A, Chalmers J, Sakkeus L, et al. Preterm birth time trends in Europe: a study of 19 countries. BJOG. 2013;120(11):1356-65.
Blondel B, Kogan MD, Alexander GR, Dattani N, Kramer MS, Macfarlane A, et al. The impact of the increasing number of multiple births on the rates of preterm birth and low birthweight: an international study. Am J Public Health. 2002;92(8):1323-30.
Euser AM, De Wit CC, Finken MJ, Rijken M, Wit JM. Growth of preterm born children. Hormone Res Paediatr. 2008;70(6):319-28.
Peralta-Carcelen M, Moses M, Adams-Chapman I, Gantz M, Vohr BR. NICHD Neonatal Research Network. Stability of neuromotor outcomes at 18 and 30 months of age after extremely low birth weight status. Pediatr. 2009;123(5):e887-95.
Mukhopadhyay K, Mahajan R, Malhi P, Kuma A. Neurodevelopmental outcome of extremely low birth weight children at corrected age of two years. 2016;53:391-3.
Setänen S, Haataja L, Parkkola R, Lind A, Lehtonen L. Predictive value of neonatal brain MRI on the neurodevelopmental outcome of preterm infants by 5 years of age. Acta Paediatr. 2013;102(5):492-7.
Patrianakos-Hoobler AI, Msall ME, Huo D, Marks JD, Plesha-Troyke S, Schreiber MD. Predicting school readiness from neurodevelopmental assessments at age 2 years after respiratory distress syndrome in infants born preterm. Dev Med Child Neurol. 2010;52(4):379-85.
Bolisetty S, Dhawan A, Abdel-Latif M, Bajuk B, Stack J, Lui K, et al. Intraventricular hemorrhage and neurodevelopmental outcomes in extreme preterm infants. Pediatr. 2014;133(1):55-62.
Patra K, Wilson-Costello D. Grades I-II intraventricular hemorrhage in extremely low birth weight infants: effects on neurodevelopment. J Pediatr. 2006;149(2):169-73.
Klebermass-Schrehof K, Czaba C. Impact of low-grade intraventricular hemorrhage on long-term neurodevelopmental outcome in preterm infants. Child’s Nerv. 2012;28(12):2085-92.
Schlapbach L, Aebischer M, Adams M. Impact of sepsis on neurodevelopmental outcome in a Swiss national cohort of extremely premature infants. Pediatr. 2011;2010.
Soraisham A, Amin H. Does necrotising enterocolitis impact the neurodevelopmental and growth outcomes in preterm infants with birthweight ≤1250 g? J Paediatr Child Health. 2006;42(9):499-504.
Hungi B, Vinekar A, Datti N, Kariyappa P. Retinopathy of prematurity in a rural neonatal intensive care unit in South India: a prospective study. Indian J. 2012;79(7):911-5.
Jalali S, Matalia J, Hussain A, Anand R. Modification of screening criteria for retinopathy of prematurity in India and other middle-income countries. Am J Ophthalmol. 2006;141(5):966-8.
Varughese S, Jain S, Gupta N, Singh S, Tyagi V. Magnitude of the problem of retinopathy of prematurity. Experience in a large maternity unit with a medium size level-3 nursery. Indian J Ophthalmol. 2001;49(3):187.
Vohr BR, Wright LL, Dusick AM, Mele L, Verter J, Steichen JJ, et al. Neurodevelopmental and functional outcomes of extremely low birth weight infants in the National Institute of Child Health and Human Development Neonatal Research Network, 1993-1994. Pediatr. 2000;105(6):1216-26.
Roth D, Hildesheimer M. Low prevalence of hearing impairment among very low birthweight infants as detected by universal neonatal hearing screening. Arch Dis. 2006;91(4):F257-62.