title: Mortality and morbidity in high risk infants during a six year follow-up.
abstract: OBJECTIVE
  To study the mortality and morbidity in high risk infants after discharge from the hospital.
  
  
  METHODS
  Prospective, 6 year follow up.
  
  
  METHODS
  High Risk Clinic (HRC).
  
  
  METHODS
  Infants discharged from a Neonatal Special Care Unit were identified for follow up using predetermined risk criteria. Home visits were made by the social worker, if appointments to HRC were missed. Verbal autopsy was performed in case of home deaths. Intercurrent illnesses and rehospitalizations were recorded. At six years, the children who had come for the final assessment at 30 months on the Bayley Scales, were recalled for assessment of the intelligence quotient, by Stanford-Binet Scale.
  
  
  RESULTS
  Four hundred and four high risk infants and eighty six controls were enrolled. There were 40 deaths in the study period, out of which 38 occurred in the first year of life, sixty per cent of these occurring in the first three months. The mortality was significantly higher in the VLBW group. Out of the 22 hospital deaths, 72.7% were due to infection. There was a significant difference (p < 0.001) in the mortality rate between the group which attended the HRC regularly (6.4%) as compared to that of the defaulters (27.6%). Ninety five children had rehospitalization in the High Risk group as compared to two in the control group (p < 0.001). In the 286 children who were assessed at 6 years, the incidence of borderline intelligence was 14.6% as compared to 5.6% in the controls (p < 0.05).
  
  
  CONCLUSIONS
  Mortality and rehospitalization rate is high in high risk infants, after discharge from the hospital. Children who appear to have normal development in the third year, may show a high incidence (14.6%) of borderline intelligence at six years.
authors: Department of Pediatrics, K.E.M. Hospital, Pune 411 011, India.
authors: S
authors: S
authors: Chaudhari
authors: S
authors: S
authors: Kulkarni
authors: A
authors: A
authors: Pandit
authors: S
authors: S
authors: Deshmukh
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology*; D005500:Follow-Up Studies; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D009017:Morbidity; D012306:Risk