NEURODEVELOPMENTAL OUTCOMES BY RAPID NEURODEVELOPMENTAL ASSESSMENT (RNDA)OF NEONATES DISCHARGED FROM NEONATAL WARD

Mustafa Mahbub*, Humaira Rafiqa Quaderi, Mahbubul Hoque, Dilara Begum, Asma Begum Shilpi, Humaira Muslima

ABSTRACT

Background: Early detection of neurodevelopmental impairments (NDIs), followed by appropriate intervention, can optimize quality of survival. Babies discharged from neonatal wards are among those at high risk. To address the lack of expertise in low and middle-income countries (LAMICs), the Rapid Neurodevelopmental Assessment (RNDA) for 0-2-year olds was validated tool which can be administered by mid-level professionals detecting a range of NDIs (primitive reflex, gross motor, fine motor, vision, hearing, speech, cognition, behavior and seizures); with severity ratings. Objective: To ascertain NDIs including seizures in babies being discharged from the neonatal ward of a national children‟s hospital by administering the RNDA. Methods: This cross-sectional study was conducted in DSH at neonatal ward between June 2011 to October 2013. Developmental Therapists routinely administered the Rapid Neurodevelopmental Assessment (RNDA) to all neonates on the day of discharge between this period. All with NDIs were provided strategies for intervention, and/or referral for further investigation when deemed necessary. All were advised to attend a Child Development Center (CDC) within the hospital or in any of the 15 CDCs within government hospitals across the country, within 3 months. Results: 900 children were assessed of whom 63.4% were boys, 44% were born preterm, 25% were from low income families. 56.7% had =>1 NDI. Specific impairments included depressed or exaggerated primitive reflexes (46.6%), and/or impairments in the following domains: gross motor (36.6%), speech (11.7%), vision (11%), cognition (10.6%), hearing (8.2%), behavior (7.6%), fine motor (3.6%). Conclusion: The RNDA is a useful method to identify very young infants on a range of neurodevelopmental domains which can provide the family a program for appropriate management and the child the hope of an optimum quality of life.

Keywords: Neurodevelopmental, neonatal, newborn, seizures.