Neuro-developmental follow up of at-risk infants at corrected ages of 9 months and 2 years: Time to do more?
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Authors
Abouelnaga, A
Tan, A.L
Stamp, R
Kapadia, J
Selkirk, L
Issue Date
2022
Type
Published Abstract
Language
Keywords
Research Subject Categories::INTERDISCIPLINARY RESEARCH AREAS::Children
Alternative Title
Abstract
Aims 1. To ensure 100% of eligible babies received appropriate neurodevelopmental follow-up.2. To explore if the current criteria for neurodevelopmental follow up can be expanded. Methods We retrospectively reviewed all infants who were eligible for neurodevelopmental assessment at 9 months and 2 years corrected gestational age in the period between January 2021 and December 2021. The assessment was carried out by the neonatal consultant and specialist physiotherapist using the Bayley Scales of Infant Development III. Our criteria for follow up included the following babies:• Gestation at birth <32 weeks • Birth weight <1500g • Required inhaled nitric oxide within the neonatal unit admission • Required therapeutic hypothermia during neonatal unit admission and Have on-going neonatal out-patient follow up at our local hospital. Results We identified 215 infants who were eligible for the 9-month neurodevelopmental follow-up in 2021. Of these, 92% of infants attended, of whom 56% were assessed face to face, whereas the rest were assessed via a video consultation (in view of the pandemic).There were 93 infants identified for the 2-year neurodevelopmental follow-up in the same year. 95% of these infants attended follow-up, of whom 95% were assessed in the face to face clinic. About 5% of infants in each category did not attend, either because they unfortunately passed away or they moved out of the area. A total of 43 referrals were made to specialist teams – around half of them to the Community Physiotherapist, 25% to the Speech and Language Therapist (SALT), 20% to the Community Paediatricians, and the remaining to the Dietician and the Audiologist. Conclusion 92% of the eligible infants were followed up for their 9 month assessment, and 95% for their 2 years assessment. It is vital that all infants who meet the criteria for follow-up are seen in this multidisciplinary forum and whilst current results for our service are very good, there are still small numbers that are lost to follow up. Recommendations We will actively chase families of infants who did not turn up in the clinic, and ensure their regular neonatal consultant is made aware.Given the high number of referrals, many of whom were at the margins of our eligibility criteria, we recommend that the eligibility criteria be broadened so that more babies can undergo this thorough and highly useful assessment. However, we are mindful of the challenges that are inherent in expanding this service. As part of our commitment to ensure early identification for timely intervention, we created a new parent information leaflet with a parent questionnaire survey to explain the reasoning behind the follow up and the preceding early physiotherapy assessments and to try to increase the understanding from parents to actively be involved in the developmental trajectory of their babies and to ensure these appointments are attended.
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Citation
Abouelnaga, A., Tan, A.L., Stamp, R., Kapadia, J. and Selkirk, L. (2022) Neuro-developmental follow up of at-risk infants at corrected ages of 9 months and 2 years: Time to do more? Archives of Disease in Childhood. 107, pp. A173-A174. DOI: 10.1136/archdischild-2022-rcpch.279