Functional measures on PEDI are associated with BSID-3 scales at 2 years, following neonatal surgery.

BACKGROUND: Neonates requiring early surgical intervention for major non-cardiac congenital anomalies are at high risk of adverse neurodevelopmental outcomes. Early recognition of potential neuro-developmental delay is critical to facilitate access to early childhood intervention services and therefore maximise the functional capabilities of these children. AIMS: This study aims to compare Bayley's Scales of Infant and Toddler Development (BSID-3) and the Paediatric Evaluation of Disability Inventory (PEDI) as early screening tools in predicting neuro-developmental disability across multiple domains. In addition, it looks at determining which pre, peri and post-operative risk factors lend themselves to more adverse outcomes. STUDY DESIGN: Retrospective cohort study. SUBJECTS: Neonates requiring surgical intervention at the Royal Children's Hospital from 2012 to 2018 who subsequently underwent neurodevelopmental assessment at 2 years of age. OUTCOME MEASURES: The main outcome was the relationship between performance on the PEDI compared with the BSID-3, in 2-year-olds following neonatal surgery. RESULTS: Parent -reported functional measures across all domains on PEDI strongly related to the more formal measures of cognition, language, and motor development assessed on BSID-3 (p < 0.05). CONCLUSIONS: The questionnaire-based PEDI tool could be considered a reliable replacement to the formal Bayley (BSID-3) scale in low-risk infants and provide a more accessible means of assessment where there are deficiencies in availability of suitably trained clinicians or limited resource centres.

Characteristics of infants at risk of hypoglycaemia secondary to being 'infant of a diabetic mother'.

BACKGROUND: Infants of diabetic mothers (IDMs) are at risk of hypoglycaemia in the neonatal period. The prediction of which of these infants are at higher risk of developing hypoglycaemia is complex. AIMS: To determine the characteristics of infants of diabetic mothers who are more likely to need an admission to the neonatal intensive care unit to manage their hypoglycaemia. METHODS: Retrospective chart review of maternal and infant characteristics of 'at-risk' infants. Electronic patient records and neonatal and obstetric database accessed to obtain data. RESULTS: A total of 326 infants were identified in a study period accessible to electronic patient records. Macrosomia was present in 15% of the infants. Hypoglycaemic episodes occurred in 109 (33.4%) infants. Maternal diabetes type, HbA1c, prematurity, macrosomia, and temperature instability were identified as risk factors most commonly associated in infants who actually went on to develop hypoglycaemia. CONCLUSIONS: A weighted risk score to predict hypoglycaemia in this at-risk population may serve to rationalise admission to the neonatal unit and management of IDMs.