Prospective Observational Follow up Study of High Risk Infants Discharged from SNCU and NICU of a Tertiary Centre in Kolkata

Abstract

Neonatal period is a period where the brain and other body systems are still immature and an insult of any type whether it be hypoxic, metabolic or infectious can have long term adverse consequences. Due to an increase in SNCU/NICU facilities and advances in the field of neonatology, neonatal mortality has decreased to some extent whereas morbidity has increased. These infants who faced insults either during the intra-uterine or neonatal period constitute the “high risk” group and many of them go on to have adverse outcomes later in life. Their management can pose a dilemma both for the parents and doctors. Follow up of high risk cases such as those with prematurity, low birth weight, perinatal asphyxia, sepsis, pathological jaundice, neonatal convulsions etc. is very important as it can help to identity infants who would require early intervention to minimize disability. Among the babies completing follow up(n=63), 15 (23.8%) were found to have developmental delay at the end of 1 year. In this study, the incidence of developmental delay among high risk infants completing follow up is quite high (23.8%) and similar to the high incidence found by Chatterjee et al. (31.6%) , Calame et al. (29%) and Shrestha et al. (28.6%).^3,7,35 The demographic characteristic of high risk babies enrolled for follow up consisted of 24 cases of perinatal asphyxia ( 9 having severe HIE and 15 having moderate HIE by Levene’s Scoring³⁶ at birth) , 21 cases of neonatal convulsion, 7 cases of invasive ventilation, 11 cases of symptomatic hypoglycemia, 31 cases of sepsis/meningitis, 45 cases of pathological jaundice of which 5 cases required double volume exchange transfusion, 15 cases having gestational age less than 34 weeks and 31 cases with a birth weight of less than 1800 grams.