The developmental status of pre-term infants on discharge from a private neonatal intensive care unit in Johannesburg

Abstract

Background Despite advances in medical management, prematurity is still responsible for 45% of neonatal deaths in South Africa. Premature infants are at risk of developing neurodevelopmental impairments. While there are numerous developmental tests that assess term infants, the Test of Infant Motor Performance (TIMP) can assess the need for neurodevelopmental intervention in infants from 34 weeks gestational age. Methods In this quantitative cross-sectional study, 30 infants with a minimal age of 34 weeks were assessed using the TIMP prior to discharge from the hospital. The study took place in a neonatal intensive care unit in a private hospital in Johannesburg, South Africa. Demographic and clinical data was collected. Results The mean gestational age was 34.33 weeks (SD 3), the mean birth weight 2.32kg (SD 0.78). The mean age of the preterm infants at testing was 37.33 weeks (SD 2.20) and the average length of stay in the NICU was 21 days. The results indicated the most prevalent condition in preterm infants to be respiratory distress syndrome (n=27) followed by jaundice (n=5) and HIV exposed non infected (n=3). The TIMP scores revealed 34% (n=10) of the infants scored below average, 3% (n=1) scored far below average, this group of infants required a referral for neurodevelopmental intervention. A total of 33% (n=10) infants scored average and 30% (n=9) scored in the low average range. Infants who had low Apgar scores at one minute were significantly more likely to score below average on the TIMP (p=0.03). Conclusion Infants born prematurely are at risk of developmental delay and would benefit from a neurodevelopmental assessment as early as 34 weeks gestational age. This could expedite early referral and intervention. Infants with low one minute APGAR scores should be prioritised for developmental assessment and referral.