RESUMO
AIM: To characterise neurodevelopmental surveillance, assessment and outcomes for infants at risk of adverse neurodevelopment and inform targeted surveillance of infants discharged from a regional tertiary neonatal centre. METHODS: A retrospective study of developmental follow-up of 106 vulnerable infants born either preterm (23-29 weeks gestation, n=96) or at ≥30 weeks gestation with low birth weight (<1,200 grams n=10) admitted to our tertiary Neonatal Intensive Care Unit between January 2011 and December 2015. Infants transferred to other regions before two-years corrected postnatal age were excluded. Local health records were reviewed to determine neurodevelopmental follow-up, input and outcomes. RESULTS: Almost all (98%) of high-risk infants received at least one follow-up visit by a visiting neurodevelopmental therapist following discharge from the neonatal unit, and 73% of infants received early developmental follow-up in line with international recommendations. Ninety infants (87%) were seen until at least two years post term, at which point 61 (68%) had typical development. At five-years post term, 23 (26%) of the 89 infants remaining in the region had been diagnosed with a developmental disability, for which global developmental disability was the most common diagnosis (19 infants). CONCLUSION: Routine neurodevelopmental surveillance of vulnerable infants from our tertiary catchment has high coverage, with most infants receiving regular developmental assessment. However, universal developmental screening is resource intense, and overall rates of diagnosed neurodevelopmental impairment are relatively low. Better early identification of infants most at risk using earlier assessment tools may help to stratify and target follow-up to allow resources to be allocated more effectively and reduce the follow-up burden for infants at lower risk of developmental concerns.
