Cognitive and motor outcomes in children born low birth weight: a systematic review and meta-analysis of studies from South Asia

Gitismita Naik,Maharaj Kishan Bhan,Rajiv Bahl,Jose Carlos Martines,Tarun Shankar Choudhary,Nita Bhandari,Ravi Prakash Upadhyay,Ranadip Chowdhury,Sunita Taneja

doi:10.1186/s12887-019-1408-8

Abstract

BackgroundSouth Asia contributes substantially to global low birth weight population (i.e. those with birth weight < 2500 g). Synthesized evidence is lacking on magnitude of cognitive and motor deficits in low birth weight (LBW) children compared to those with normal birth weight (NBW) (i.e. birth weight ≥ 2500 g). The meta-analysis aimed to generate this essential evidence.MethodsLiterature search was performed using PubMed and Google Scholar. Original research articles from south Asia that compared cognitive and/or motor scores among LBW and NBW individuals were included. Weighted mean differences (WMD) and pooled relative risks (RR) were calculated. All analyses were done using STATA 14 software.ResultsNineteen articles (n = 5999) were included in the analysis. Children < 10 years of age born LBW had lower cognitive (WMD -4.56; 95% CI: -6.38, − 2.74) and motor scores (WMD -4.16; 95% CI: -5.42, − 2.89) compared to children with NBW. Within LBW children, those with birth weight < 2000 g had much lower cognitive (WMD -7.23, 95% CI; − 9.20, − 5.26) and motor scores (WMD -6.45, 95% CI; − 9.64, − 3.27).ConclusionsIn south Asia, children born LBW, especially with < 2000 g birth weight, have substantial cognitive and motor impairment compared to children with NBW. Early child development interventions should lay emphasis to children born LBW.

Highlights

Lower middle income countries (LMICs), as per the recent World Bank criteria, are those with a gross national income (GNI) per capita between USD 996 and 3895 [1]
Evidence is lacking from south Asian setting on magnitude of cognitive and motor deficits in low birth weight (LBW) individuals compared to those with normal birth weight (NBW)
Our meta-analysis showed that LBW children < 10 years of age had 4.56 points lower cognitive and 4.16 points lower motor scores compared to children with NBW

Summary

Introduction

Lower middle income countries (LMICs), as per the recent World Bank criteria, are those with a gross national income (GNI) per capita between USD 996 and 3895 [1]. Infants born with low birth weight have been identified to be at an increased risk of adverse outcomes other than mortality, such as predisposition to stunting, wasting and impaired neurodevelopment outcomes [3,4,5,6,7,8]. Evidence on the quantum and nature of growth and development impairment in LBW infants compared to NBWs (i.e. with birth weight ≥ 2500 g) would help prioritize and aid in design of postnatal programs. The evidence from LMICs, including south Asia, is available for growth but lacking for neurodevelopment. A recent systematic review incorporating data from 137 developing countries has documented low birth weight, including prematurity and foetal growth restriction, as a leading risk factor for childhood stunting at 2 years of age [8].

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Results

Discussion

Conclusion