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Updated: May 19, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Assessment of Neurodevelopmental Outcomes Using the Developmental Assessment Scale for Indian Infants and Growth
Mangla Sood1, Shagun Kaushal1, Rajender Thakur1
1Pediatrics, Indira Gandhi Medical College, Shimla, IND.
Insights
Neurodevelopmental delays in high-risk infants decreased by 12 months but persisted in some. Key risk factors for delays include shock, hypoxic-ischemic encephalopathy (HIE), and meningitis.
Area of Science:
- Neonatal care
- Pediatric neurology
- Developmental pediatrics
Background:
- High-risk infants require specialized follow-up to monitor neurodevelopmental outcomes and growth.
- Early identification of developmental trajectories and risk factors is crucial for timely intervention.
Purpose of the Study:
- To assess neurodevelopmental outcomes and growth in high-risk infants after discharge from a level 3 newborn unit.
- To identify risk factors associated with developmental delays in this vulnerable population.
Main Methods:
- Longitudinal follow-up of 296 high-risk infants.
- Anthropometric measurements using WHO Anthro software at 3, 6, 9, and 12 months corrected age (CA).
- Neurodevelopment assessment using the Developmental Assessment Scale for Indian Infants (DASII) at 6 and 12 months CA; logistic regression for risk factor analysis.
Main Results:
- 194 infants completed 12-month follow-up; 7 died, 95 lost to follow-up.
- Motor delay observed in 12.6% at 6 months and 7.7% at 12 months; mental delay in 4% at 6 months and 3.6% at 12 months.
- Strongest predictors for 12-month motor delay: shock, hypoxic-ischemic encephalopathy (HIE), meningitis. Significant predictors for mental delay included HIE, shock, meningitis, and prolonged ventilator support.
Conclusions:
- Neurodevelopmental delays decreased by 12 months but persisted in a subset of high-risk infants.
- Shock, HIE, and meningitis are the strongest predictors of neurodevelopmental delay.
- Growth faltering was most prominent in early weight/length indices and later in head circumference.
Objective:
To assess neurodevelopmental outcomes and growth in high-risk infants post discharge from a level 3 newborn unit.
Methodology:
Eligible high-risk infants were enrolled in this longitudinal follow-up study, and anthropometric measurements were interpreted using the WHO Anthro software (WHO, Geneva, Switzerland) at three, six, nine, and 12 months corrected age (CA). Neurodevelopment assessment was done using the Developmental Assessment Scale for Indian Infants (DASII) at six- and 12-month CA. Logistic regression analysis was used to identify risk factors associated with developmental delays.
Result:
Among 296 high-risk infants, 194 completed 12-month follow-up; seven died (2.4%), and 95 were lost to follow-up. Motor delay affected 29 (12.6%) at six months and 15 (7.7%) at 12 months; corresponding figures for mental delay were nine (4%) and seven (3.6%). At 12 months, the strongest predictors of motor delay were shock (OR: 78.1; 95% CI: 26.6, 228), hypoxic-ischemic encephalopathy (HIE) (OR: 65.5; 95% CI: 14.1, 304), and meningitis (OR: 25.9; 95% CI: 8.2, 82.1). Significant predictors for mental delay included HIE (OR: 92.6; 95% CI: 12, 113.6), shock (OR: 79.6; 95% CI: 23.3, 271.7), meningitis (OR: 42; 95% CI: 9.3, 188), and ventilator support >24 hours (OR: 13; 95% CI: 6.4, 26.6). Other factors like birth weight <1000 grams (OR: 5.7; 95% CI: 2.0, 15.9) and sepsis (OR: 2.6; 95% CI: 1.4, 4.9) also remain significant risks throughout the first year. Growth faltering was greatest for weight/length-for-age Z-scores at three months and head circumference at nine months.
Conclusion:
Neurodevelopmental delays declined by 12 months but persisted in a vulnerable subset, with shock, HIE, and meningitis emerging as the strongest predictors. Growth faltering was most evident in early weight/length indices and later in head circumference.
