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Multidomain Intervention for Growth in Term Small-for-Gestational-Age Infants: A Randomized Clinical Trial
Ranadip Chowdhury1, Rukman Manapurath1,2, Ravi Prakash Upadhyay1
1Society for Applied Studies, New Delhi, India.
JAMA
|July 27, 2026
Summary
An integrated intervention significantly improved growth and neurodevelopment in small-for-gestational-age (SGA) infants. This multidomain approach reduced undernutrition and developmental delays, promoting better health outcomes for these vulnerable newborns.
Area of Science:
- Pediatrics
- Public Health
- Developmental Psychology
Background:
- Small-for-gestational-age (SGA) infants are at high risk for undernutrition and developmental delays.
- Multidomain interventions are crucial for optimizing growth and neurodevelopment in SGA infants.
Purpose of the Study:
- To assess the impact of an integrated intervention package on the growth and neurodevelopment of term SGA infants.
Main Methods:
- A randomized clinical trial involving 1300 term SGA infants in low-resource South Delhi neighborhoods.
- Infants received either an integrated intervention (health, nutrition, stimulation, psychosocial support) or usual care.
- Primary outcomes included weight and weight-for-age z-score at 12 months; secondary outcomes covered linear growth, neurodevelopment, anemia, and mortality.
Main Results:
- The intervention group showed significantly improved weight (0.22 kg difference) and weight-for-age z-scores (0.24 difference) at 12 months.
- Lower prevalence of underweight, stunting, wasting, and anemia was observed in the intervention group.
- Enhanced cognitive, language, and motor scores were noted in infants receiving the integrated intervention.
Conclusions:
- An integrated, multidomain intervention effectively improved growth and neurodevelopment in term SGA infants.
- This approach offers a promising strategy to mitigate the long-term health risks associated with SGA.