INTRODUCTION

Neonatal hypoglycaemia is a complication seen in preterm, small-for-gestational-age, infants of diabetic mothers and rarely term infants. Clinical phenotype of Neonatal Hypoglycaemic Brain Injury (NHBI) is not well characterised even in India, where incidence is perceived to be amongst highest worldwide.

AIM

Our aim was to assess neurodevelopmental outcomes pertaining to cognition, language skills (receptive/expressive communication) and motor skills (fine and gross) with corticovisual impairment (CVI) in infants/children with NHBI.

METHODOLOGY

In our prospective cross-sectional cohort (ongoing) study 15 consecutive subjects diagnosed radiologically and / or clinically with NHBI were recruited.

Subjects were assessed using Bayley –III scales and CVI range. Data was compared to age referenced norms.

RESULTS

• Microcephaly was commonly seen
  • OFC < 2^nd centile: 7/15
  • Between 2^nd- 9^th: 6/15
  • > 50^th : 2/15
• Bayley’s scores < 2 standard deviations (SD) by domain:
  • All domains affected: 70% patients
  • Fine motor: 93 % - most affected
  • Cognitive: 86%
  • Receptive/ expressive communication and Gross motor: 65%
• CVI range scores:
  • 1-2 (least use of vision): 50%
  • 3-4, 5-6,7-8 (impaired vision): 75 %
  • 9-10 (normal): 25 %
• 60%: feeding difficulties at birth
• 66%: acute symptomatic seizures

CONCLUSION

Early detection / prevention of NHBI is as important as instituting surveillance/ early intervention.

Defining clinical phenotype is crucial in creating awareness re neurological sequelae of NHBI- hence encouraging prevention and aiding early detection and intervention.