A TO STUDY TO ASSESS THE INCIDENCE OF NEUROLOGICAL ABNORMALITY IN HIGH-RISK NEONATES IN OUR NEONATAL INTENSIVE CARE UNIT

Aim: The present study is an attempt to study incidence of neurological abnormality in high-risk neonates in our neonatal intensive care unit and to find out association with antenatal, perinatal and neonatal factors for predicting risk for deviant development.

Methods: The study was conducted at Department of Paediatrics, NIMS Medical College and Hospital, Jaipur from October 2022 to September 2024. 75 subjects were included in the study.

Results: The study population included 64(85.3%) preterm and 11(14.7%) term neonates. Out of 75 newborns, 63 were born by LSCS, 3 required vacuum assistance, while rest 9 were born by normal vaginal delivery. In the study group 57 were AGA, 12 were SGA and 6 were LGA. Head circumference was normal in 63 newborns, 1 had definite abnormality. 9 of the infants although did not have microcephaly for their GA, their head size was small for their weight/ length.  Anterior fontanel was normal in all while 10 had definite cranial suture abnormality. Neurosensory abnormality was seen in 13 newborns (17.3%). In them, 7 had moderate abnormality while 6 had definitive abnormality. At 40 weeks the moderately abnormal & definite abnormal neurological assessment were highest in 35-36+6wk gestation age group i.e. 10(52.6%) & 3(15.8%) respectively.

Conclusion: High risk newborns have increased Incidence (10.6%) of neurological abnormality in comparison to overall newborn population (4-5%). Those newborns who were neurologically normal and those who were definitively abnormal, remained so even at follow up. Moderate abnormal newborns are likely to improve and unlikely to deteriorate. Fetal distress was one of the common and major risk factors for neurological disabilities in the newborn both at 40 wks of gestational age(p=0.021) and also at 3months of age (p=0.018). Prematurity and IVF conception by themselves did not appear to be a risk factor for abnormal neurological outcome in the newborn. Use of antenatal steroids appear to decrease incidence of neurological abnormality in the newborn(P<0.001).