Neuromotor and Neurosensory Impairment among High Risk Infants at One Year of Age – Risk Factor Analysis

Abstract

Background: Improvement in the quality of perinatal care in the last few decades has led on to improve newborn survival. Sick neonates who have survived are exposed to high risk factors in the prenatal period and are termed as high risk infants (HRIn). This study aimed at determining the proportion of neuromotor and neurosensory impairments among HRIn. Methods: This prospective observational study was conducted in a tertiary care centre in South India between January 2020 and December 2021. Study population comprised of intramural high risk infants fulfilling the criteria. At discharge infants were stratified as mild, moderate or severe risk for developing neurodevelopmental disorders and follow up plan was given. The subjects were assessed at 4, 6, 8 and 12 month for impairments. Results: Total 138 infants were enrolled and 88 completed follow up. Lost for follow up was 36.2%. The impairments detected with respect to motor and vision were 12.5% and 1.1% respectively. Sepsis, seizures, birth asphyxia and preterm were robust prognostic factors for neuromotor impairment. Risk of tone abnormality was 13 times higher in infants who had sepsis. At risk for developmental delay was noticed in 11.4% of the study for which significant association was with prematurity, sepsis and birth asphyxia. Discussion: HRIn are susceptible for neurodevelopmental impairments. Hence early identification and enrolment in intervention programs will ensure favorable outcomes.