Burden of neurologic disease in a peruvian neonatal intensive care unit
2014
Objectives : To determine the frequency of neurologic disease in hospitalized newborns Methods : Observational, descriptive, retrospective study. Pediatric neurology evaluations were reviewed for all babies admitted between June 2008 and September 2012. Results : 1626 neonates (11.1% of total hospitalized population) required neurologic evaluation. 803 of these were VLBW babies. 877 neurologic problems diagnosed before discharge. 178 cases of intraventricular hemorrhage (20.29% of total neurologic cases) were detected by routine ultrasonography, 29.8% were bilateral. 39.8% IVH cases were severe (III grade IVH or periventricular infarction). IVH was present in 19.7% of VLBW babies and 33.7% of ELBW babies. Periventricular leucomalacia was present in 28/803 VLBW babies (3.48%). Most common problem in term babies was neonatal encephalopathy (190 patients, 21.6% of neurologic disease), 24.7% cases (47 newborns) were definite or probable cases of hypoxic ischemic encephalopathy. CNS malformations were frequent (123 patients, 14% of neurologic diseases), neural tube defects were the most common (28/123, 22.7%), as were corpus callosum anomalies (20 cases), holoprosencephaly (15 cases) and Moebius syndrome (16 cases). 49 patients were diagnosed with perinatal trauma, most frequent lesion was brachial plexus injury (30 patients). 41 patients had CNS infections (4.6% of neurologic disease), 31 of them presented acute meningitis. Stroke was diagnosed in 29 patients, 13 of which presented as hydranencephaly. 5 patients were admitted for cranial injuries. 25 patients had neonatal seizures for causes not listed above. Conclusions: Neurologic disease is frequent in hospitalized newborns. Attention must focused on severe, preventable injury and follow up.
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