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Introduction

Follow-up management is important for both catch-up
growth assessment and neurological assessment.

For inquires: Pediatrics Department 031-782-8372(KOR) / +82-10-8866-2268(ENG)

Follow-up management is important for both catch-up growth assessment and neurological assessment.

For inquires: Pediatrics Department
031-782-8372(KOR) / +82-10-8866-2268(ENG)
Outpatient follow-up management system after discharge from the NICU
The first outpatient visit is planned within 7 to 10 days after discharge to assess proper accommodation at home. After that, it is decided according to the patient's condition, and if there are no special problems, 3 to 6 months is appropriate. Follow-up visits at 4-6 months of age is an important period for both catch-up growth assessment and neurologic assessment. During corrected age of 8-12 months, it is appropriate for assessing neurological development, and to have an initial developmental test. In the corrected age of 18 to 24 months, many transient neurological abnormalities improve, and even when there are neurological abnormalities, it’s a time when adaptation takes place and the cognitive function is evaluated. Problems with academic achievement or emotional development may be discovered later. For children born at or before 28 weeks gestation, follow-up at age 4 is also recommended since these children will often need special education.
A. Purpose of outpatient follow-up

1. Early detection of developmental disorders

2. Consultation with guardians

3. Discovery and treatment of medical complications

4. Receive medical specialist’s feedback

B. For who : all patients discharged from the NICU

Intensive follow-up care is required, especially in the following cases:

1. Babies born before 32 weeks gestation

2. Babies with a growth delay below the third percentile compared to their age

3. Babies with moderate to high perinatal asphyxia

4. Babies who received intensive care when they were born

5. If a disease requiring follow-up care is discovered during hospitalization (congenital heart disease, gastroesophageal reflux, etc.)

6. At high-risk for developmental disabilities

  • Premature babies: if the birth weight was less than 750g or was born earlier than 25 weeks gestation
  • Presence of brain damage
    • Bleeding or infarction around the ventricles of the brain
    • Softening around the ventricles of the brain
    • Continuously showing enlarged ventricles of the brain
    • Showing signs of convulsions
    • History of meningitis
    • Small head at the time of discharge
  • Intrauterine growth restriction
  • Perinatal asphyxia
  • Chronic lung disease
  • Other risk factors
    • Congenital infection (i.e. TORCH)
    • Severe infection during infant period (sepsis, meningitis, etc.)
    • Hypoglycemia, erythropoiesis
    • Mother’s medication intake during pregnancy
C. Outpatient follow-up and evaluation

1. Evaluate physical growth

2. Measure blood pressure

3. Observe breathing

4. Hearing Test – ENT specialist

5. Vision Test – ophthalmology specialist

6. Check for neurological diseases
Motor dysfunction (stiffness bilateral paralysis, limb paralysis, unilateral paralysis), mental retardation, convulsions, sensory dysfunction (hearing, vision, premature retinopathy, eye movement disorders), hydrocephalus after hemorrhage, disorders of schoolchildren (visual-motor dysfunction), learning disorders, mild neurological disorders, attention deficit hyperactivity disorder)

  • Neurological diseases that can occur in a child who has a history of being admitted in the NICU :
    • Cerebral palsy
    • Convulsions
    • Hydrocephalus
    • Hearing loss
    • Visual impairment
    • Mental retardation
  • Movement disorders
    High-risk for developing movement disorders include micro-preemies, intraventricular hemorrhage, pericardial leukomalacia, severe perinatal asphyxia, severe intrauterine developmental delay, and chronic lung disease. (Premature infants less than 32 weeks gestation or birth weight is less than 1500g are treated by the Rehabilitation Department at corrected age of 4 months, and at corrected age of 2 months if intraventricular hemorrhage or periventricular leukomalacia is diagnosed.)
  • Developmental disabilities – rehabilitation, oral rehabilitation, nutrition counseling, and pediatric psychiatry is scheduled for further specialized care