Developmental outcome of neonatal intensive care unit graduates born in tertiary care hospital in South India

Abstract

Background: With the advancement in technology and advances in perinatal care, survival rates of high risk newborns have improve. Despite the reduction in neonatal mortality, chronic morbidities and adverse outcomes have not declined. These include cerebral palsy, cognitive delay, visual and auditory deficits signifying the need for regular monitoring of growth and development.

Methods: Retrospective and prospective cohort study in a tertiary care centre in South India. Study duration of one year. Retrospective analysis of data of 190 high risk newborns admitted in NICU for more than 48 hours during the period 2012-2014. Neurodevelopmental outcome of these high-risk newborns at the age of 8-10 years. These were contacted and followed up for clinical assessment including motor and neurological function, visiomotor integrative skills, academic achievement, language, executive function, behavioral issues and child behavioral checklist applied. Findings described in simple descriptive manner.

Results: In this study of 190 babies,139 babies were followed up for clinical assessment at the age of 8-10 years. From the follow up, 7.2% were diagnosed to have seizure disorder during childhood. 18.7% had hyperactive airway disease during childhood. 9.8% had academic problems, 5.8% had motor abnormalities, 2.9% had vision abnormalities requiring glasses from early childhood, 4.3% had gait abnormalities, 4.9% had speech related difficulties,17.3% had behavioral issues including excessive anxiety, withdrawal, aggressiveness. 1.2% had sleep problems, 21.6% babies had features of attention deficit hyperactivity disorder, 2.9% had features related to autism.

Conclusions: Neonatal period is a critical period for proper neurodevelopment, having impact on child development. Babies with difficulties during transition period had higher immediate as well as long term morbidities. Long term morbidities included hyperactive airway disease/asthma, seizure disorder, academic problems, motor and gait abnormalities, behavioural abnormalities in childhood.