Impact of neonatal jaundice and neurological complications on developmental outcomes among children under 3 years of age

Authors

  • Nancy Rana Department of Nutrigenomics and Cancer Biology Lab, Vadodara, Gujarat, India; Department of Zoology, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara, Gujarat, India; Dr. Vikram Sarabhai Institute of Cell and Molecular Biology, Vadodara, Gujarat, India
  • Ronak Pandit Department of Clinical Child Psychology, Kashiben Gordhandas Patel Children Hospital (KGPCH), Vadodara, Gujarat, India
  • Hetal Roy Department of Nutrigenomics and Cancer Biology Lab, Vadodara, Gujarat, India; Department of Zoology, Faculty of Science, The Maharaja Sayajirao University of Baroda, Vadodara, Gujarat, India; Dr. Vikram Sarabhai Institute of Cell and Molecular Biology, Vadodara, Gujarat, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20263314

Keywords:

Neurodevelopmental delay, DASII, Neonatal jaundice, Neurological complications, Developmental quotient

Abstract

Background: Neurodevelopmental delay (NDD) remains major concern in early childhood, particularly among infants exposed to perinatal complications. Neonatal jaundice (NJ) and neurological complications (NC) are common in high-risk infants and can adversely affect brain development, yet detailed clinical profiling of developmental domains in such populations is limited in hospital-based Indian settings. 

Methods: In this study, we assessed patterns of NDD using the Developmental Assessment Scale for Indian Infants (DASII) in a cohort of 30 children aged up to 30 months attending tertiary care centre in Vadodara, Gujarat. Children were grouped based on clinical profiles into Group-I, those with NJ and/or NC and Group-II, those with other medical conditions.

Results: The median age at assessment was 21.3 months. NC (60%) and NJ (43.3%) were the most common perinatal conditions, with frequent overlap. Overall, children showed marked developmental delay, with median motor and mental developmental quotient (DQ) of 47 and 42, respectively. Mental developmental impairment was consistently greater and less variable than motor impairment across both groups. Moderate to severe delay was observed in 50% children in motor domain and 70% in mental domain. Children in Group-I showed more uniform and pronounced impairment, particularly in mental domain. Cluster-wise analysis revealed predominant deficits in body control and manipulation in motor domain, and social interaction and imitative behaviour in mental domain.

Conclusion: These findings highlight the significant impact of early-life neurological and bilirubin-related insults on child development and underscore the importance of early identification and targeted intervention using culturally appropriate tools such as DASII.

References

Murugalatha P, Ramya K, Balasubramanian M, Balasankar S, Mumina KM. Assessment of neurodevelopmental outcome of preterm very low birth weight babies at the corrected age of 1 year. Int J Acad Med Pharm. 2023;5(2):517-21.

Wusthoff CJ, Loe IM. Impact of bilirubin-induced neurologic dysfunction on neurodevelopmental outcomes. Semin Fetal Neonatal Med. 2015;20(1):52-7.

Grantham-McGregor S, Cheung YB, Cueto S, Glewwe P, Richter L, Strupp B, et al. Developmental potential in the first 5 years for children in developing countries. Lancet. 2007;369(9555):60-70.

Verma B, Chhabra P, Maroof AK, Aggarwal A. Developmental delay and its associated factors among children of 9 months and of 18 months attending primary health facilities in an urban resettlement area of East Delhi. J Family Med Prim Care. 2024;13(12):5674-9.

Venugopal GS, Jayan G, Binu GJ, Lawrence T. Prevalence and determinants of developmental delay among children below two years of age visiting an immunization clinic of a tertiary care centre in South India. Int J Contemp Pediatr. 2024;11(10):1406-13.

Bhattacharya T, Ray S, Das DK. Developmental delay among children below two years of age: a cross-sectional study in a community development block of Burdwan district, West Bengal. Int J Community Med Public Health. 2017;4(5):1762-8.

Black MM, Walker SP, Fernald LCH, Andersen CT, DiGirolamo AM, Lu C, et al. Early childhood development coming of age: science through the life course. Lancet. 2017;389(10064):77-90.

Bansal G, Arora A, Jajoo M, Malhotra S. Impact of Hyperbilirubinemia on Neurodevelopmental Outcomes in Term and Late Preterm Neonates: A Prospective Observational Study in A Tertiary care NICU. 2025.

Magai DN, Mwaniki M, Abubakar A, Mohammed S, Gordon AL, Kinyanjui S, et al. Neonatal jaundice and developmental impairment among infants in Kilifi, Kenya. Child Care Health Dev. 2020;46(3):336-44.

Villagomez AN, Muñoz FM, Peterson RL, Colbert AM, Hensley DM, Akech S, et al. Neurodevelopmental delay: Case definition & guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine. 2019;37(52):7623-41.

Woodgate P, Jardine LA. Neonatal jaundice. BMJ Clin Evid. 2011;2011:0811.

Merino‐Andrés J, Pérez‐Nombela S, Álvarez‐Bueno C, Hidalgo‐Robles Á, Ruiz‐Becerro I, Fernández‐Rego FJ. Neonatal hyperbilirubinemia and repercussions on neurodevelopment: A systematic review. Child Care Health Dev. 2024;50(1):e13180.

Dubey P, Shrivastava J, Choubey BP, Agrawal A, Thakur V. Neurodevelopmental outcome of healthy term newborn with serum bilirubin >15 mg/dl at one year. J Neonatal Perinatal Med. 2021;14(3):339-44.

Tsao PC, Yeh HL, Shiau YS, Chang JH, Chiu NC, Chiang SH, et al. Long-term neurodevelopmental outcomes of significant neonatal jaundice in Taiwan from 2000–2003: a nationwide, population-based cohort study. Sci Rep. 2020;10(1):11374.

Kumar V, Kumar P, Sundaram V, Munjal SK, Malhi P, Panda NK. Childhood neurodevelopmental outcomes of survivors of acute bilirubin encephalopathy: A retrospective cohort study. Early Hum Dev. 2021;158:105380.

Chattopadhyay N, Mitra K. Neurodevelopmental Outcome of High Risk Newborns Discharged from Special Care Baby Units in a Rural District in India. 2015.

Seo SY, Shim GH, Chey MJ, You SJ. Prognostic factors of neurological outcomes in late-preterm and term infants with perinatal asphyxia. Korean J Pediatr. 2016;59(11):440-5.

Kang SK, Kadam SD. Neonatal Seizures: Impact on Neurodevelopmental Outcomes. Front Pediatr. 2015;3:101.

Lappegård J, Lyeng UB, Støen R, Vanky E, Brubakk AM, Vik T. Neonatal Seizures Were Associated With Higher Mortality, Epilepsy and Cerebral Palsy in Term‐Born Children up to 5 Years of Age. Acta Paediatr. 2026.

Garfinkle J, Shevell MI. Prognostic factors and development of a scoring system for outcome of neonatal seizures in term infants. Eur J Paediatr Neurol. 2011;15(3):222-9.

Modi R, Patel J, Mishra A. Neurodevelopmental outcome of high-risk newborns discharged from NICU in a tertiary-care hospital of western India. Int J Med Sci Public Health. 2016;5(7):1350-4.

Madaan P, Saini L, Sondhi V. Development Assessment Scale for Indian Infants: A Systematic Review and Perspective on Dwindling Cutoffs. Indian J Pediatr. 2021;88(9):918-20.

Mukhopadhyay K, Mahajan R, Malhi P, Kumar P. Neurodevelopmental outcome of extremely low birth weight children at corrected age of two years. Indian Pediatr. 2016;53(5):391-3.

Phatak P. Manual for Using Developmental Assessment Scale for Indian Infants (DASII); Based on Revised Baroda Norms. Pune, India: Anand Agencies; 1997.

Taneja V, Sriram S, Beri RS, Sreenivas V, Aggarwal R, Kaur R. 'Not by bread alone': impact of a structured 90-minute play session on development of children in an orphanage. Child Care Health Dev. 2002;28(1):95-100.

Upadhyay D, Singh S, Dwivedi D. Effect of Nutritional Rehabilitation on Neurodevelopmental Status of Children With Severe Acute Malnutrition. Indian Pediatr. 2024;61(10):935-40.

Gunasekaran V, Ighodaro ET, Govil-Dalela T. Neonatal Seizures and Neonatal Epilepsy. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2026. Available at: https://www.ncbi.nlm.nih.gov/books/NBK580536/. Accessed on 12 March 2026.

Choi Y, Park S, Lee H. Neonatal Jaundice Requiring Phototherapy Risk Factors in a Newborn Nursery: Machine Learning Approach. Children. 2025;12(8):1020.

Koul R, Al-Yahmedy M, Al-Futaisi A. Evaluation Children with Global Developmental Delay: A Prospective Study at Sultan Qaboos University Hospital, Oman. Oman Med J. 2012;27(4):310-3.

Downloads

Published

2026-09-23

How to Cite

Rana, N., Pandit, R., & Roy, H. (2026). Impact of neonatal jaundice and neurological complications on developmental outcomes among children under 3 years of age. International Journal of Contemporary Pediatrics, 13(10), 2080–2089. https://doi.org/10.18203/2349-3291.ijcp20263314

Issue

Section

Original Research Articles