Neuro developmental and growth patterns among preterm very low birth weight (vlbw) & extremely low birth weight (elbw) babies at one year corrected gestational age, a follow up study

Background: Advances in the neonatal management has led to increase in survival of most very low birth weight and extremely low birth babies resulting in surge in number of infants with aberrations in growth and department. Early detection of such aberrations leads to marked improvement in ultimate outcome of such children. Methods: A hospital based case control follow up study was under taken in the department of pediatrics Government medical college Srinagar.72 out of 78 preterm low birth weight and extremely low birth weight who survived to discharge were registered as cases and 64 term babies admitted as suspected sepsis were registered as controls after ruling out sepsis between January 2014 to June 2014 .Gestational age was estimated by recommended methods and serial computation of Z-scores was done from anthropometric measurements at different intervals during first year of life. Neurodevlopmental assessment was done at one year corrected age using Denver Developmental screening test. Hearing assessment was done by transient evoked otoacoustic emissions and auditory brainstem responses. Screening for Retinopathy of prematurity was done per set protocol. Data was analyzed by standard statistical methods. Results: Among VLBW and ELBW infants, there was a significant decline in Z-scores of all three anthropometric parameters from birth to discharge. Thereafter they showed increasing trend throughout infancy. However, all anthropometric Z-scores of these infants continued to be significantly lower than NBW infants (P<0.05).Six infants among cases and none among controls had developmental delay at one year corrected age.18 cases had evidence of retinopathy of prematurity more so in extremely low birth babies .Three infants among cases had significant hearing impairment. Conclusion: Very low birth and extremely low birth babies remain smaller, lighter and have significantly lower neurodevelopmental indices at one year corrected age as compared to normal birth weight counterparts despite advances in neonatal care, a challenge for neonatal care providers.