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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neurodevelopmental outcomes of preterm babies during infancy in Eastern Uganda: a prospective cohort study
Gertrude Namazzi1, James K Tumwine2, Helena Hildenwall3,4,5
1Maternal Newborn and Child Health Centre of Excellence, Makerere University School of Public Health, College of Health Sciences , Kampala, Uganda.
Insights
Preterm infants face a high risk of neurodevelopmental disability (NDD), particularly those with malnutrition. Kangaroo Mother Care (KMC) at home can reduce NDD risk, highlighting the need for improved follow-up care.
Area of Science:
- Neonatal Health
- Pediatric Neurodevelopment
- Global Child Survival
Background:
- Complications from prematurity pose significant risks to child survival and development, especially in low-income regions.
- Preterm infants are particularly vulnerable to long-term health challenges.
Purpose of the Study:
- To assess neurodevelopmental outcomes in preterm infants.
- To identify modifiable factors associated with neurodevelopmental disability (NDD) in this population.
Main Methods:
- A cohort study involving 454 infants (242 preterm, 212 term) was conducted from May to July 2018.
- Neurodevelopmental outcomes were assessed at an average of 7 months using the Malawi Developmental Assessment tool.
- Maternal interviews gathered data on infant care practices.
Main Results:
- The incidence of NDD was significantly higher in preterm infants (20.4%) compared to term infants (7.5%).
- Fine motor and language domains were most affected.
- Malnutrition increased the odds of NDD (OR=2.92), while Kangaroo Mother Care (KMC) reduced the odds (OR=0.46).
Conclusions:
- Preterm infants, especially those with malnutrition, are at high risk for NDD.
- Improved health system follow-up focusing on nutrition and consistent Kangaroo Mother Care (KMC) is crucial.
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.
