Every new born baby has to go through a complex process of growth and development at various levels to ultimately emerge as a normal adult. Any deviation in these stages of development will lead to developmental disability. Such disability may express in various forms, which include mental retardation, cerebral palsy, autism, attention deficit disorders, visual and hearing problems, speech and language disorders, learning disabilities and many more. These problems increase as birth weight decreases. Impaired neurodevelopmental outcome is a major long-term complication of surviving premature infants, especially extremely premature infants who are born at or below 32 weeks gestation.1-2 Sick neonates, particularly preterm babies, very low birth weight (VLBW) and extremely low birth weight (ELBW) babies (birth weights less than 1500 and 1000 g respectively) with perinatalhypoxia and hypoxic-ischaemic encephalopathy, sepsis, severe jaundice, etc. are most vulnerable to poor neuro-developmental outcome.3These are classified as high risk infants. Insult to the developing brain may lead to gross and fine structural changes resulting in smaller brain size, reduced white and grey matter, ventriculomegaly, decreased callosal projections and altered fibre tract organization, which eventually affects neural function.4 Hence, a close neuro-developmental follow-up of these high-risk newborns is essential for early detection of any brain damage, to prevent or restrict a poor neuro-developmental outcome through early intervention. Intrauterine and neonatal insults substantially affect the global burden of disease, measured in disability-adjusted life-years, because they contribute to both premature mortality and long-term disability.5 However, little is known about the severity and distribution of long-term impairments after intrauterine or neonatal insults. As a result, sequelae from intrauterine and neonatal insults have not been adequately captured in estimates of the global burden of disease.6,7 In India, unfortunately, there is not enough awareness about the abovementioned facts and that neurodevelopment assessment has long been considered the domain of pediatric neurologist, and general paediatricians often fail to recognize the delay that had begun to set in the neonatal intensive care unit (NICU) graduate that had come to him for various medical problems. Though perinatal and newborn care is improving in rural India, a section of the rural population is still deprived of all the available facilities, due to socio-economic, cultural and topographical reasons. There is very scanty data from this part of the globe, regarding neuro-devel-opmental outcome of high risk newborns and the magnitude of the problem of evolving developmental challenges, hence we remain oblivious of the gravity of the situation. This opportunity is big one to miss because, it was at this point, if early intervention done to modify social and psychosocial environment of the infant would have made a large difference to his eventual neurodevelopment outcome.​ Recognition of precipitating factors and adequate preventive measures, detection of early markers of developmental delay and early intervention measures can go a long way in preventing childhood disability.8 This calls in for a neuro-developmental follow-up of high risk babies by a specialized team, using proper scientific methodology.9 With this background, we will venture to follow up high risk babies discharged from the Tertiary Newborn Care unit at wardha, a district of Maharashtra, India to study the prevalence of delayed development in high risk babies and identify their various aetiological factors and associations. Simultaneous provision of early intervention will also initiated as a preventive and therapeutic measure. |