Impact of neonatal jaundice and neurological complications on developmental outcomes among children under 3 years of age

Abstract

Background: Neurodevelopmental delay (NDD) remains major concern in early childhood, particularly among infants exposed to perinatal complications. Neonatal jaundice (NJ) and neurological complications (NC) are common in high-risk infants and can adversely affect brain development, yet detailed clinical profiling of developmental domains in such populations is limited in hospital-based Indian settings.  Methods: In this study, we assessed patterns of NDD using the Developmental Assessment Scale for Indian Infants (DASII) in a cohort of 30 children aged up to 30 months attending tertiary care centre in Vadodara, Gujarat. Children were grouped based on clinical profiles into Group-I, those with NJ and/or NC and Group-II, those with other medical conditions. Results: The median age at assessment was 21.3 months. NC (60%) and NJ (43.3%) were the most common perinatal conditions, with frequent overlap. Overall, children showed marked developmental delay, with median motor and mental developmental quotient (DQ) of 47 and 42, respectively. Mental developmental impairment was consistently greater and less variable than motor impairment across both groups. Moderate to severe delay was observed in 50% children in motor domain and 70% in mental domain. Children in Group-I showed more uniform and pronounced impairment, particularly in mental domain. Cluster-wise analysis revealed predominant deficits in body control and manipulation in motor domain, and social interaction and imitative behaviour in mental domain. Conclusion: These findings highlight the significant impact of early-life neurological and bilirubin-related insults on child development and underscore the importance of early identification and targeted intervention using culturally appropriate tools such as DASII.