ICNC Abstracts, ICNC 2018

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Assessment of Neurodevelopmental Status in Infants and Children with Neonatal Hypoglycemic Brain Injury –characterise the Spectrum of Neurodisability (6-42 months)- Pilot Study
pradnya gadgil, Vidhi Shah, Shailee Shah, Abhishek Srivastava

Last modified: 2018-09-09

Abstract


INTRODUCTION

Neonatal hypoglycaemia is a complication seen in preterm, small-for-gestational-age, infants of diabetic mothers and rarely term infants. Clinical phenotype of Neonatal Hypoglycaemic Brain Injury (NHBI) is not well characterised even in India, where incidence is perceived to be amongst highest worldwide.

AIM

Our aim was to assess neurodevelopmental outcomes pertaining to cognition, language skills (receptive/expressive communication) and motor skills (fine and gross) with corticovisual impairment (CVI) in infants/children with NHBI.

METHODOLOGY

In our prospective cross-sectional cohort (ongoing) study 15 consecutive subjects diagnosed radiologically and / or clinically with NHBI were recruited.

 

Subjects were assessed using Bayley –III scales and CVI range. Data was compared to age referenced norms.

 

RESULTS

  • Microcephaly was commonly seen
    • OFC < 2nd centile: 7/15
    • Between 2nd- 9th: 6/15
    • > 50th : 2/15
  • Bayley’s scores < 2 standard deviations (SD) by domain:
    • All domains affected: 70% patients
    • Fine motor: 93 % - most affected
    • Cognitive: 86%
    • Receptive/ expressive communication and Gross motor: 65%
  • CVI range scores:
    • 1-2 (least use of vision): 50%
    • 3-4, 5-6,7-8 (impaired vision): 75 %
    • 9-10 (normal): 25 %
  • 60%: feeding difficulties at birth
  • 66%: acute symptomatic seizures

CONCLUSION

Early detection / prevention of NHBI is as important as instituting surveillance/ early intervention.

 

Defining clinical phenotype is crucial in creating awareness re neurological sequelae of NHBI- hence encouraging prevention and aiding early detection and intervention.

 


Keywords


Neonatal Hypoglycaemia; Neonatal Hypoglycemic Brain Injury; Seizures; Bayleys Assessment; Developmental Delay; Corticovisual Impairment

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