Assessment of Neurodevelopmental Outcomes Using the Developmental Assessment Scale for Indian Infants and Growth Patterns Among High-Risk Infants From a Special Newborn Care Unit in Northern India: A Longitudinal Study.

OBJECTIVE

To assess neurodevelopmental outcomes and growth in high-risk infants post discharge from a level 3 newborn unit.

METHODOLOGY: Eligible high-risk infants were enrolled in this longitudinal follow-up study, and anthropometric measurements were interpreted using the WHO Anthro software (WHO, Geneva, Switzerland) at three, six, nine, and 12 months corrected age (CA). Neurodevelopment assessment was done using the Developmental Assessment Scale for Indian Infants (DASII) at six- and 12-month CA. Logistic regression analysis was used to identify risk factors associated with developmental delays.

RESULT: Among 296 high-risk infants, 194 completed 12-month follow-up; seven died (2.4%), and 95 were lost to follow-up. Motor delay affected 29 (12.6%) at six months and 15 (7.7%) at 12 months; corresponding figures for mental delay were nine (4%) and seven (3.6%). At 12 months, the strongest predictors of motor delay were shock (OR: 78.1; 95% CI: 26.6, 228), hypoxic-ischemic encephalopathy (HIE) (OR: 65.5; 95% CI: 14.1, 304), and meningitis (OR: 25.9; 95% CI: 8.2, 82.1). Significant predictors for mental delay included HIE (OR: 92.6; 95% CI: 12, 113.6), shock (OR: 79.6; 95% CI: 23.3, 271.7), meningitis (OR: 42; 95% CI: 9.3, 188), and ventilator support >24 hours (OR: 13; 95% CI: 6.4, 26.6). Other factors like birth weight <1000 grams (OR: 5.7; 95% CI: 2.0, 15.9) and sepsis (OR: 2.6; 95% CI: 1.4, 4.9) also remain significant risks throughout the first year. Growth faltering was greatest for weight/length-for-age Z-scores at three months and head circumference at nine months.

CONCLUSION

Neurodevelopmental delays declined by 12 months but persisted in a vulnerable subset, with shock, HIE, and meningitis emerging as the strongest predictors. Growth faltering was most evident in early weight/length indices and later in head circumference.