Growth and neurodevelopmental outcome of high risk premature neonates at 1 year in a tertiary level NICU of central India

Abstract

Background: To study the outcome of growth and development till one year of age of very preterm neonates and moderate to late preterm admitted and discharged from a tertiary level NICU in central India.Methods: 120 preterm babies admitted and discharged from NICU were enrolled consecutively. Out of them 82 were followed up for a period of 1 year. Physical parameter like weight, length and head circumference were recorded on admission and at 1, 3, 6 and 12 months of corrected gestational age. Developmental assessment was done at 12 months of corrected gestational age by DASII (developmental assessment scale for Indian infants).Results: Among the 82 enrolled subjects 28 were very preterm (28-<32 weeks) and 54 were moderate to late preterm (32-<37 weeks). Overall growth (all the anthropometric parameters) was higher in the moderate to late preterm group. In very preterm babies weight gain was better from 6-12 months of postnatal age and was statistically significant (p<0.005). Length gain was higher in very premature babies group but not statistically significant and head growth was significantly higher in very preterm babies from 1 month to 1 year compared to moderate to late preterm babies (p<0.05). Neurodevelopmental delay was seen in 28% (n=23) of the study group at 1 year, 65.2% (n=15) were very preterm babies. Associated risk factors were RDS, hypoglycemia, NEC and sepsis. Developmental quotient was lower in very preterm (66.45) compared to moderate preterm babies (79.86).Conclusions: Prematurity and its associated complications are linked to adverse physical and neurodevelopmental outcomes. Improved perinatal care, early assessment of development by appropriate tools and early intervention is a must to improve the outcome of these babies.