Growth And Neurodevelopment Outcome Of Infants Requiring Respiratory Support In NICU

Abstract

The primary goals of perinatal care are to decrease infant morbidity and mortality, enhance health-related quality of life, and improve neurodevelopmental outcomes in high risk infants. Neurodevelopmental outcome is increasingly used as the benchmark to determine efficacy of medical interventions in infants. Follow up is necessary to identify possible negative effects that a medical intervention or standard of care might have on the child's brain. Nasal positive airway pressure (NCPAP) use for premature and respiratory distresss due to many causes has recently been widely used in neonatal intensive care unit. It has been shown to lower the intubation rate and shorten O2 therapy and other complication which may affect growth and neurodevelopmental outcome. The patients on mechanical ventilators need longer duration on the ventilation than patients on NCPAP. The study aimed to assess growth and neurodevelopmental outcome of infants placed on NCPAP and/or mechanical ventilator in neonatal intensive care units until the age of 18 months. The study included 120 neonates divided as: 40 fullterm infants suffering from respiratory distress and put on mechanical ventilator and/or NCAP (GroupI) were subdivided into 20 fullterm infants supported by MV followed by NCPAP (Subgroup IA) and 20 fullterm infants supported by NCPAP only (Subgroup IB). 40 preterm infants suffering from respire-tory distress and put on mechanical ventilator and/or NCAP (Group II) were subdivided into 20 preterm infants supported by MV followed by NCPAP (Subroup IIA) and 20 preterm infants supported by NCPAP only (Subgroup IIB). 20 full-terms didn’t need admission to NICU as control group for fullterm infants (Group III). 20 preterm didn’t need admission to NICU as control group for preterm infants (Group IV). All groups were subjected to full prenatal, natal and postnatal history, also full data about there stay in NICU. All groups were followed at 3, 6, 12 and 18 months after birth. And all were subjected in each visit to the following:  Assessment of weight, length and head circumference using the Egyptian Growth Charts.  Neurodevelopmental assessment using Griffiths Mental and Developmental score. Cases were propeply matched as shown by GA and birth weigth that showed no statistically significant difference. The result of our study revealed that there was no significan