Neurologic sequelae in high risk infants--a three year follow up

To determine the neurologic sequelae in high risk infants.

A three year longitudinal follow up.

Inborn and outborn infants discharged from the Neonatal Special Care Unit (NSCU) of a referral hospital.

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.

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%.

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.