Abstract
Background: Recent advances in medicine has improved the overall management of premature infants who are in turn at risk of developing developmental problems. This area of research is currently explored to limited extent.
Methods: This is a longitudinal study of very low birth weight infant (VLBW) survivors born between 2017 and 2020 and were followed up to assess their developmental outcomes till 3 years. All neonates have been assessed with general examination and clinical history and factors associated with poor outcomes were evaluated.
Results: Thirty-four neonates with a mean age of 2.4±0.5 years (Range 2-3) with equal male to female ratio 17(50%) were included. The mean gestational age was 32.8 months (Range 27.2-37.6). Their mean birth weight was 1.3±0.2kg. Majority were born Preterm 22(64.7%) and only a few 7(20.6%) were adequate for gestational age. Respiratory distress and fetal cervical hyperextension were commonly diagnosed in these infants. Developmental abnormalities were noted in 8(23.5%) infants. The most common development issues were gross motor in 4(50%), fine motor 3(37.5%), vision 3(37.5%), and language 2(25%) impairment. The mean age of these were 31.7 years, mean weight was 1.2kg, 6(75%) were small for gestational age, 4(50%) had respiratory distress.
Conclusions: Among VLBW survivors a significant one quarter (23.5%) proportion of infants had poor developmental outcomes. VLBW infants can develop learning difficulties at school and need long-term follow up.
Keywords: Very low birth weight infants, developmental impairments, Preterm, Outcomes.
References
- EXPRESS Group; Fellman V, Hellström-Westas L, Norman M, et al. One-year survival of extremely preterm infants after active perinatal care in Sweden. JAMA. 2009 Jun 3;301(21):2225-33.
- Arora S, Yadav P, Bajaj H, et al. Improving clinical outcomes of very low birth weight infants: Implementation of standardized management guidelines in tertiary care hospital in Haryana. Int J Pediatr Adolesc Med. 2020 Dec;7(4):174-180.
- Aylward GP: Neurodevelopmental outcomes of infants born prematurely. J Dev Behav Pediatr. 2005, 26 (6): 427-40.
- Hack M. Survival and neurodevelopmental outcomes of preterm infants. J Pediatr Gastroenterol Nutr. 2007, 45 (Suppl 3): S141-2.
- Delobel-Ayoub M, Kaminski M, Marret S, et al; EPIPAGE Study Group. Behavioral outcome at 3 years of age in very preterm infants: the EPIPAGE study. Pediatrics. 2006 Jun;117(6):1996-2005.
- Kabilan S, Kumar MS. Morbidity and mortality pattern of very low birth weight infants admitted in SNCU in a South Asian tertiary care centre. Int J Contemp Pediatr. 2018; 5:720– 5.
- Mooorthi MMS, Nadesan B, Ramalingam E, et al. A study of maternal factors influencing very low birth weight babies. Int J Contemp Pediatr. 2017; 4:1173–8.
- Chaudhari S, Otiv M, Chitale A, et al. Pune low birth weight study -cognitive abilities and educational performance at twelve years. Ind Pediatr. 2004;41:121-8.
- Larroque B, Ancel PY, Marret S, et al. Neurodevelopmental disabilities and special care of 5- year old children born before 33 weeks of gestation (the EPIPAGE study): A longitudinal cohort study. Lancet. 2008;371:813-20.
- Coughlin M, GibbinsS, HoathS. Core measures for developmentally supportive care in neonatal intensive care units: theory, precedence and practice. J Adv Nurs.2209; 65(10): 2239–2248.
- Modi M, Saluja S, Kler N, et al. Growth and neurodevelopmental outcome of VLBW infants at 1 year corrected age. Indian Pediatr. 2013;50:573-7.
- Radhika S, Sobhakumar S, Soumya S, et al. Growth and neurodevelopmental outcome of very low birth weight babies at 1 year of age. J Med Sci Clin Res. 2017;5: 23836-23840.
- Lugli L, Bedetti L, Guidotti I, et al. Neuroprem 2: An Italian Study of Neurodevelopmental Outcomes of Very Low Birth Weight Infants. Front Pediatr. 2021 Sep 13;9:697100.
- Wilkinson D, Andersen C, O'Donnell CP, De Paoli AG, Manley BJ. High flow nasal cannula for respiratory support in preterm infants. Cochrane Database Syst Rev. 2016 Feb 22;2(2):CD006405.
- Smith JR. Early enteral feeding for the very low birth weight infant: the development and impact of a research-based guideline. Neonatal Netw. 2005 Jul-Aug;24(4):9-19.
- O’Grady Naomy P, Alexander Mary, Burns Lillian A, et al. Guidelines for the prevention of intravascular catheter related infections. Clin Infect Dis. 2011;52(9):162–193.
Corresponding Author
Dr Shruti Dhale
Associate Professor, Department of Pediatrics, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India - 400001
DOI: https://dx.doi.org/10.18535/jmscr/v11i6.08
