Neurodevelopmental outcomes of preterm babies during infancy in Eastern Uganda: a prospective cohort study.
Birth Weight
Child Development
/ physiology
Cohort Studies
Female
Humans
Infant
Infant Nutrition Disorders
/ epidemiology
Infant, Newborn
Infant, Premature
/ growth & development
Kangaroo-Mother Care Method
/ statistics & numerical data
Malawi
Male
Neurodevelopmental Disorders
/ epidemiology
Prevalence
Prospective Studies
Uganda
/ epidemiology
KMC
Neurodevelopmental disability
infants
malnutrition
prematurity
Journal
Global health action
ISSN: 1654-9880
Titre abrégé: Glob Health Action
Pays: United States
ID NLM: 101496665
Informations de publication
Date de publication:
31 12 2020
31 12 2020
Historique:
entrez:
6
10
2020
pubmed:
7
10
2020
medline:
10
3
2021
Statut:
ppublish
Résumé
Complications due to prematurity are a threat to child survival and full developmental potential particularly in low-income settings. The aim of the study was to determine the neurodevelopmental outcomes among preterm infants and identify any modifiable factors associated with neurodevelopmental disability (NDD). We recruited 454 babies (242 preterms with birth weight <2.5 kg, and 212 term babies) in a cohort study at birth from Iganga hospital between May and July 2018. We followed up the babies at an average age of 7 months (adjusted for prematurity) and assessed 211 preterm and 187 term infants for neurodevelopmental outcomes using the Malawi Developmental Assessment tool. Mothers were interviewed on care practices for the infants. Data were analyzed using STATA version 14. The study revealed a high incidence of NDD of 20.4% (43/211) among preterm infants compared to 7.5% (14/187) among the term babies, p < 0.001, of the same age. The most affected domain was fine motor (11.8%), followed by language (9.0%). At multivariate analysis, malnutrition and Kangaroo Mother Care (KMC) at home after discharge were the key factors that were significantly associated with NDD among preterm babies. The prevalence of malnutrition among preterm infants was 20% and this significantly increased the odds of developing NDD, OR = 2.92 (95% CI: 1.27-6.71). KMC practice at home reduced the odds of developing NDD, OR = 0.46, (95% CI: 0.21-1.00). Re-admission of preterm infants after discharge (a sign of severe illness) increased the odds of developing NDD but this was not statistically significant, OR = 2.33 (95% CI: 0.91-5.94). Our study has shown that preterm infants are at a high risk of developing NDD, especially those with malnutrition. Health system readiness should be improved to provide follow-up care with emphasis on improving nutrition and continuity of KMC at home.
Sections du résumé
BACKGROUND
Complications due to prematurity are a threat to child survival and full developmental potential particularly in low-income settings.
OBJECTIVE
The aim of the study was to determine the neurodevelopmental outcomes among preterm infants and identify any modifiable factors associated with neurodevelopmental disability (NDD).
METHODS
We recruited 454 babies (242 preterms with birth weight <2.5 kg, and 212 term babies) in a cohort study at birth from Iganga hospital between May and July 2018. We followed up the babies at an average age of 7 months (adjusted for prematurity) and assessed 211 preterm and 187 term infants for neurodevelopmental outcomes using the Malawi Developmental Assessment tool. Mothers were interviewed on care practices for the infants. Data were analyzed using STATA version 14.
RESULTS
The study revealed a high incidence of NDD of 20.4% (43/211) among preterm infants compared to 7.5% (14/187) among the term babies, p < 0.001, of the same age. The most affected domain was fine motor (11.8%), followed by language (9.0%). At multivariate analysis, malnutrition and Kangaroo Mother Care (KMC) at home after discharge were the key factors that were significantly associated with NDD among preterm babies. The prevalence of malnutrition among preterm infants was 20% and this significantly increased the odds of developing NDD, OR = 2.92 (95% CI: 1.27-6.71). KMC practice at home reduced the odds of developing NDD, OR = 0.46, (95% CI: 0.21-1.00). Re-admission of preterm infants after discharge (a sign of severe illness) increased the odds of developing NDD but this was not statistically significant, OR = 2.33 (95% CI: 0.91-5.94).
CONCLUSION
Our study has shown that preterm infants are at a high risk of developing NDD, especially those with malnutrition. Health system readiness should be improved to provide follow-up care with emphasis on improving nutrition and continuity of KMC at home.
Identifiants
pubmed: 33019912
doi: 10.1080/16549716.2020.1820714
pmc: PMC7580792
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1820714Références
J Pediatr. 1991 Sep;119(3):417-23
pubmed: 1880657
Arch Dis Child. 2020 Feb;105(2):134-140
pubmed: 31300408
PLoS Med. 2010 May 25;7(5):e1000273
pubmed: 20520849
Neurology. 2013 Dec 10;81(24):2082-9
pubmed: 24212394
Trials. 2018 Jun 5;19(1):313
pubmed: 29871696
PLoS Med. 2011 Nov;8(11):e1001121
pubmed: 22087079
Lancet. 2012 Feb 4;379(9814):445-52
pubmed: 22244654
Am Fam Physician. 2007 Oct 15;76(8):1159-64
pubmed: 17990838
BMC Pregnancy Childbirth. 2013;13 Suppl 1:S10
pubmed: 23445560
J Perinatol. 1996 Nov-Dec;16(6):483-9
pubmed: 8979190
BMC Pediatr. 2019 Nov 4;19(1):403
pubmed: 31684894
Lancet. 2005 Mar 19-25;365(9464):1087-98
pubmed: 15781104
Matern Child Nutr. 2020 Oct;16(4):e13026
pubmed: 32525271
J Pediatr. 2003 Aug;143(2):163-70
pubmed: 12970627
J Perinatol. 2009 May;29(5):343-51
pubmed: 19148113
BMJ. 2017 Aug 16;358:j3448
pubmed: 28814566
Lancet Glob Health. 2019 Jan;7(1):e37-e46
pubmed: 30389451
Acta Paediatr. 2015 Oct;104(10):974-86
pubmed: 26179961
Semin Fetal Neonatal Med. 2017 Feb;22(1):42-48
pubmed: 27692935
J Perinat Med. 2011 Sep;39(5):579-86
pubmed: 21740330
JAMA. 2000 Oct 18;284(15):1939-47
pubmed: 11035890
Acta Paediatr. 2016 Jun;105(6):587-99
pubmed: 26813585
Cochrane Database Syst Rev. 2016 Aug 23;(8):CD002771
pubmed: 27552521
BMC Pediatr. 2018 Oct 15;18(1):326
pubmed: 30322374
Matern Child Nutr. 2018 Jan;14(1):
pubmed: 28585371
BMC Pregnancy Childbirth. 2015;15 Suppl 2:S1
pubmed: 26390820
Arch Dis Child Fetal Neonatal Ed. 2017 May;102(3):F235-F234
pubmed: 27758929
Pediatr Res. 2013 Dec;74 Suppl 1:17-34
pubmed: 24366461
BMC Pediatr. 2019 Oct 24;19(1):379
pubmed: 31651279
PLoS One. 2018 Nov 21;13(11):e0207156
pubmed: 30462671
Pediatrics. 2001 Nov;108(5):1072-9
pubmed: 11694683
Curr Opin Pediatr. 2015 Apr;27(2):254-60
pubmed: 25635585
BMC Pediatr. 2020 Apr 4;20(1):150
pubmed: 32247311
Lancet Glob Health. 2017 Dec;5(12):e1275-e1282
pubmed: 29102350