Neurodevelopmental Assessment of High Risk Infants Graduated from Neonatal Intensive Care Unit

Abstract

present study was designed to evaluate the neuroevelomental predictive value of Clinical Risk Index for Babies (CRIB) score, in Hypoxic ischemic ecephlopthy (H.I.E) infants. Also, the diagnostic value of Early Motor Pattern Profile (EMPP) for motor handicap was compared to the Bayley Scales of Infant and Toddler Development Third Edition. In our study, Sixty full term (gestational age ≥ 37 weeks) neonates were enrolled, they comprised two groups; groupI (H.I.E) that included thirty neonates with hypoxic ischemic encephalopathy (11males & 19 females) who didn’t undergo hypothermia or any other intervention within the first 6 hours of life; their mean birth weight was 2.75 ± 0.61 kg.Group II (Control) that included 30 apparently healthy infants (15 males &15 females); their mean birth weight was2.97 ± 0.24 kg. All participants in the study were subjected to (first visit) perinatal history documentation; anthropometry &Bayley scales of infant and toddler development third edition, and 3 months later (second visit) were subjected to anthropometry, Bayley scales of infant and toddler development third edition & EMPP. Regarding birth measurments H.I.E group had lower birth weights and first visit weights compared to control group &there was no difference in the follow up visit. They had lower OFC initially and at follow up compared to control group and there was no difference regarding the length either primarily or in the follow up visit. In the present study, birth assessment revealed negative correlation between Apgar score at 10 min with Sarnat & Sarnat staging system.Also, positive correlation between CRIB score with Sarnat& Sarnat staging system. As regading the Correlations between birth assessment with Bayley scale items in the first visit for H.I.E case revealed that there were positive correlations between Apgar score at (5& 10 min) with Language scale (first visit), While there was negative correlation between Sarnat&Sarnat Staging system with Motor scale (first visit). As regading the Correlations between birth assessments with Bayley scale items in the second visit for H.I.E case revealed that; there were negative correlations between CRIB Score with Cognitive scale & Language scale (second visit). Also, there were negative correlations between Sarnat&Sarnat Staging system with all main scales of BayleyIII in the follow up visit. Moving to the comparison between H.I.E & Control groups in first & second visits in Bayley-III scale, H.I.E infants’ scores were lower than the Control infants’ in all main Bayley-III scales in the first visit. Moving to the second visit, they had lower Cognitive and Motor scales composite scores, with no difference in the Language scale score.