Iranian Journal of Neonatology

Iranian Journal of Neonatology

Neurological Examination and Hearing Assessment of Premature Infants with Gestational Age of Less Than 32 Weeks at Follow-up

Document Type : Original Article

Authors
Arif Vohra 1
Jolly Vaishnav 2
Nargis Pathan 3
1 Department of Pediatrics, B. J. Medical College, Civil Hospital Campus, Ahmedabad, India
2 Department of Pediatrics, B. J. Medical College, Ahmedabad, India
3 Shurya Hospital, Mumbai, India
10.22038/ijn.2023.70541.2375
Abstract
Background: The survival of premature infants has improved in the recent era due to advances in perinatal and neonatal healthcare practices. These infants are at risk of neuro-sensorimotor impairment, as well as learning and behavioral disorders.
Methods: A longitudinal follow-up study was planned over 6 months at a High-Risk Clinic, Civil Hospital, Ahmedabad, India, to conduct the neurological examination and hearing assessment of premature infants born with gestational age less than 32 weeks. Infants who were born preterm at <32 weeks of gestational age and those attending the high-risk clinic at 3, 6, 9, and 12 months of corrected gestational age were enrolled in the study. These infants were assessed for tone via the Amiel-Tison method and hearing impairment via BERA.
Results: During the study period, 69 infants were included with a mean gestational age of 30.4±1.2 weeks. On the assessment of tone, at 3 months of corrected age, 3 and 1 infants had hypertonia and hypotonia, respectively. At 6 months of corrected age, 4 and 3 infants had hypertonia and hypotonia, respectively. Moreover, 1 and 2 infants had hypertonia and hypotonia at 9 months of corrected age, respectively, and 1 infant had hypertonia at 12 months of corrected age. Out of 69 enrolled infants, 5 (7%) infants had hearing loss at 3 months of corrected gestational age, whereas 64 (93%) infants had normal hearing assessment via BERA at the corrected gestational age of 3 months.
Conclusion: Preterm infants are at very high risk of neurodevelopmental impairment and need frequent follow-up visits and early intervention.
 
 
Keywords
Hearing assessment
Neurological examination
Premature infants

  1. . WHO. Preterm birth. national health portal of India. 2022.Availablefrom:https://www.nhp.gov.in/disease/reproductive-system/female-gynaecological-diseases-/preterm-birth

    1. Lawn JE, Kinney M. Preterm birth: now the leading cause of child death worldwide. Sci Transl Med. 2014; 6(263):263ed21.
    2. Moore T, Hennessy EM, Myles J, Johnson SJ, Draper ES, Costeloe KL, et al. Neurological and developmental outcome in extremely preterm children born in England in 1995 and 2006: the EPICure studies. BMJ. 2012; 345.
    3. Stoll BJ, Hansen NI, Bell EF, Walsh MC, Carlo WA, Shankaran S, et al. Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993-2012. JAMA. 2015; 314(10):1039-51.
    4. Vijayakumar B, Beligere N, Perumalswamy V, Tandon M, Mittal A, Floora J, et al. Retinopathy of prematurity and neurodevelopmental disabilities in premature infants. Seminars in Fetal & Neonatal Medicine; 2015.
    5. McCarraher-Wetzel AP, Wetzel RC. A review of the Amiel-Tison neurologic evaluation of the newborn and infant. Am J Occup Ther. 1984; 38(9):585–93.
    6. Stephens BE, Vohr BR. Neurodevelopmental Outcome of the Premature Infant. Pediatr Clin North Am. 2009; 56(3):631–46.
    7. Sun H, Xu F, Xiong H, Kang W, Bai Q, Zhang Y, et al. Characteristics of respiratory distress syndrome in infants of different gestational ages. Lung. 2013; 191:425-33.
    8. Oommen SP, Santhanam S, John H, Roshan R, Swathi TO, Padankatti C, et al. Neurodevelopmental outcomes of very low birth weight infants at 18–24 months, corrected gestational age in a tertiary health center: a prospective cohort study. J Trop Pediatr. 2019; 65(6):552–60.
    9. Ferreira RC, Mello RR, Silva KS. Neonatal sepsis as a risk factor for neurodevelopmental changes in preterm infants with very low birth weight. J Pediatr. 2014; 90:293-9.
    10. Fanaroff AA, Stoll BJ, Wright LL, Carlo WA, Ehrenkranz RA, Stark AR, et al. Trends in neonatal morbidity and mortality for very low birthweight infants. Am J Obstet Gynecol. 2007; 196(2):147-e1.
    11. Devi GV, Bhuvaneswari M, Prasad GR. Clinical profile and outcome of term and preterm newborns with hyperbilirubinemia admitted in SNCU of a teaching hospital. J Evid Based Med Health. 2015; 2:2228-36.
    12. Grether JK, Nelson KB, Emery III ES, Cummins SK. Prenatal and perinatal factors and cerebral palsy in very low birth weight infants. J Pediatr. 1996; 128(3):407-14.
    13. Nair BK, Sharma J, Chaudhary S. Clinicoetiological profile of neonatal seizure in a newborn care unit of a tertiary care teaching hospital in Northern India. J Clin Neonatol. 2020; 9(1):27-31.
    14. Jalali S, Anand R, Kumar H, Dogra MR, Azad R, Gopal L. Programme planning and screening strategy in retinopathy of prematurity. Indian J Ophthalmol. 2003; 51(1):89-97.

    16  Mukhopadhyay K, Malhi P, Mahajan R, Narang A. Neurodevelopmental and behavioral outcome of very low birth weight babies at corrected age of 2 years. Indian J Pediatr. 2010; 77:963-7

     

Iranian Journal of Neonatology
Volume 14, Issue 2
Spring 2023
Pages 40-45