title: Prediction of Neurodevelopmental Outcome of Preterm Babies Using Risk Stratification Score.
abstract: OBJECTIVE
  To study the incidence of major neurodevelopmental disability (NDD) at 1 y age (corrected for prematurity) in a cohort of preterm Indian babies (≤33 wk) and to predict NDD based on perinatal risk factors.
  
  
  METHODS
  This prospective cohort study was conducted at a referral neonatal intensive care unit (NICU) with a developmental follow up clinic in private sector in Kerala, India. The study was conducted for 4.5 y - January 2005 to July 2009. All preterm babies ≤33 wk at birth, discharged from the NICU were included. Pre-defined perinatal and neonatal risk factors known to affect neurodevelopmental outcome were recorded prospectively, in a structured form. Babies were followed to 1 y of age, corrected for prematurity and classified as normal or as having major neurodevelopmental disability (NDD). Major NDD was defined as cerebral palsy or Development Assessment Scale for Indian Infants (DASII) motor /mental score <70 or blindness in one or both eyes or hearing impairment needing hearing aids.
  
  
  RESULTS
  The incidence of major NDD at 1 y age (corrected for prematurity) among the 225 preterm babies was 6.2 %. A clinical score was devised by combining 5 risk factors, gestation ≤28 wk, need for extensive resuscitation at birth, symptomatic hypoglycemia, invasive ventilation for >7 d and abnormal neurosonogram. Scores of 1 to 5 were associated with 4, 6, 10, 25, 100 % risk of major NDD respectively (p < 0.01). The authors could stratify 87.5 % of the babies into low risk (score of 1 or 2) for NDD and 12.5 % into high risk (score 3 or 4 or 5) for major NDD.
  
  
  CONCLUSIONS
  Majority of the preterm babies at lower risk of NDD need less intensive follow up, while those at higher risk (12.5 %) should be guided to more frequent structured follow up and early intervention program.
authors.affiliation: Department of Neonatology, Kerala Institute of Medical Sciences, Anayara, Thiruvananthapuram, 695029, Kerala, India. radhikaajith@gmail.com.
authors.forename: Radhika
authors.identifier: http://orcid.org/0000-0003-4785-3556
authors.initials: R
authors.lastname: Sujatha
authors.affiliation: Department of Neonatology, Kerala Institute of Medical Sciences, Anayara, Thiruvananthapuram, 695029, Kerala, India.
authors.forename: Naveen
authors.initials: N
authors.lastname: Jain
mesh_terms: D002547:Cerebral Palsy; D002657:Child Development; D002658:Developmental Disabilities; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D018570:Risk Assessment
keywords: Neurodevelopmental disability; Perinatal risk factors; Prediction; Preterm birth