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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
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Neurodevelopmental outcomes for high-risk neonates in a low-resource setting
Kate M Milner1,2,3, Trevor Duke1,2,4, Andrew C Steer1,2,4
1Department of Paediatrics, Centre for International Child Health, University of Melbourne, Melbourne, Victoria, Australia.
Archives of Disease in Childhood
|August 30, 2017
Summary
High-risk neonates in low-resource settings face a higher risk of neurodevelopmental impairment (NDI). Key factors like prematurity and birth complications significantly increase NDI risk, highlighting the need for improved care.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Global health
Background:
- Most premature and critically ill neonates in low-resource settings lack developmental outcome data and follow-up.
- Fiji, a Pacific island nation, presents a typical low-resource environment for assessing neonatal outcomes.
Purpose of the Study:
- To determine the prevalence and risk factors of moderate to severe neurodevelopmental impairment (NDI) in early childhood among high-risk neonates in Fiji.
- To compare NDI rates in high-risk neonates versus a control group of healthy, full-term neonates.
Main Methods:
- A retrospective cohort study compared 149 high-risk neonatal intensive care unit (NICU) survivors with 147 matched term, normal birth weight controls.
- Neurodevelopmental impairment (NDI) was defined using the Bayley Scales of Infant and Toddler Development Third Edition, identifying cerebral palsy, severe sensory impairment, or global developmental delay (score <70).
Main Results:
- At a median age of 36.1 months, the prevalence of moderate to severe NDI was 12% in the high-risk group versus 5% in controls (Risk Ratio: 2.7).
- Significant risk factors for NDI in high-risk neonates included lower gestational age, low birth weight, asphyxia, meningitis, and respiratory distress.
- The high-risk group included predominantly term infants (median gestational age 37.5 weeks).
Conclusions:
- Moderate to severe NDI is prevalent in high-risk neonatal survivors in this low-resource setting, even among those born at term.
- Identified risk factors underscore the need for enhanced neonatal care quality and structured follow-up programs for high-risk infants in similar settings.
