Related Experiment Videos
Neurologic sequelae in high risk infants--a three year follow up
S Chaudhari1, S Kulkarni, S Barve
1Department of Pediatrics, K.E.M. Hospital, Pune.
Insights
This study followed high-risk infants to assess neurologic sequelae. Major handicaps were infrequent, suggesting preventable adverse outcomes with improved antenatal and perinatal care.
Area of Science:
- Neonatal neurology
- Pediatric neurodevelopmental outcomes
- High-risk infant follow-up
Background:
- Neonatal Special Care Units (NSCUs) manage high-risk infants.
- Longitudinal follow-up is crucial for assessing neurodevelopmental trajectories.
- Identifying neurologic sequelae early can guide interventions.
Purpose of the Study:
- To determine the incidence and types of neurologic sequelae in high-risk infants.
- To evaluate neurodevelopmental outcomes over a three-year period.
- To correlate risk factors with adverse neurologic outcomes.
Main Methods:
- A three-year longitudinal follow-up study of inborn and outborn infants.
- Neurodevelopmental assessments using Amiel-Tison Method, Bayley Scales, and Raval's Scale.
- EEG, hearing, and ophthalmic assessments were performed as indicated.
Main Results:
- 16% of high-risk infants developed cerebral palsy, often with associated mental retardation.
- Six percent of infants had mental retardation without motor deficits.
- Sensorineural hearing loss and cortical blindness were observed in a small percentage of infants.
Conclusions:
- The overall incidence of major neurologic handicaps in this high-risk infant cohort was low.
- Many adverse outcomes identified may be preventable with optimal antenatal and perinatal care.
- Early and regular neurodevelopmental follow-up is essential for high-risk neonates.
Objective:
To determine the neurologic sequelae in high risk infants.
Design:
A three year longitudinal follow up.
Setting:
Inborn and outborn infants discharged from the Neonatal Special Care Unit (NSCU) of a referral hospital.
Methods:
High risk infants were identified for follow up using predetermined risk criteria. A detailed neurodevelopmental examination was done 3 monthly in the first year and 6 monthly subsequently. The Amiel-Tison Method, Bayley Scales of Infant Development and Raval's Scale for social maturity were used. EEG was done in children with seizures. Hearing and ophthalmic assessments were done at 6 months.
Results:
Three hundred and thirty six high risk infants and 70 normal control infants came for regular follow up. Out of these, 16 (4.8%) had cerebral palsy and 11 had associated mental retardation. Six other children had mental retardation without motor problems. None of the children in the control group had any neurological problems. Sensorineural hearing loss was present in 5 (1.5%) children while 1 subject had corfical blindness. Three children with cerebral palsy had infantile myoclonus, nine had generalized seizures and one child had a focal seizure. The incidence of seizure disorders was 3.9%.
Conclusions:
The incidence of major handicap in our study was low. Many of the risk factors which caused adverse outcome, could have been prevented by good antenatal and perinatal care.