Neurodevelopmental outcomes in newborns with birth asphyxia with special reference to hearing and visual impairment

Abstract

Background: Birth asphyxia, the commonest cause of neonatal hospital admission with involvement of majority of an infant's organs but brain impairment is particularly worrisome. Early, severe neurologic dysfunction indicates significant hypoxic-ischemic insult and is the best predictor of neurologic sequelae. The survivors suffer from hypoxic–ischemic brain injury affecting vulnerable areas of the brain leading to neurodevelopmental sequelae including problems with sensory-motor, auditory and language processing. Methods: This prospective cohort study conducted at Neonatal Section of JNMCH, AMU, Aligarh included 150 asphyxiated newborns fulfilling inclusion criteria. The discharged newborns were followed at 6,10 and 14 weeks and 6 months for neurological assessment using HINES along with screening assessment of visual and hearing. The findings noted compared with different Stages of HIE. Results: Among a total of 150 eligible asphyxiated newborn enrolled in the study, 91 babies were discharged. 89% of the Stage I HIE discharged infant had HINES score of more than 70 at 6 months whereas score of more than 65 was seen in 96%, 81% and 35% in the three advancing stages of HIE respectively. All babies in stage I, 77% of stage II and 50% of stage III babies had normal ophthalmological examination. All babies with stage III had an abnormal hearing. Conclusions: Majority of asphyxiated newborn of Stage I and II were having good hospital as well as neurodevelopment and visual outcome but the Stage III babies had high mortality and adverse neurological, ophthalmic and hearing sequalae in the survivors.