Abstract
Children born with low birth weight (LBW) tend to have lower neurodevelopmental scores compared to term normal birth weight children. It is important to determine factors that influence neurodevelopment in these low birth weight children especially in the first 2-3 years of life that represents a period of substantial brain development. This secondary data analysis was conducted using data from LBW infants enrolled soon after birth in an individually randomized controlled trial (RCT) and followed up till end of 1st year. Neurodevelopmental assessment was done at 12 months of corrected age by trained psychologists using Bayley Scales of Infant and Toddler Development 3rd edition (Bayley-III). Factors influencing cognitive, motor and language scores were determined using multivariable linear regression model. Linear growth (i.e., length for age z score, LAZ) [cognitive: Standardized ẞ-coefficient = 2.19, 95% CI; 1.29, 3.10; motor: 2.41, 95% CI; 1.59, 3.23; language: 1.37, 95% CI; 0.70, 2.04], stimulation at home [cognitive: 0.21, 95% CI; 0.15, 0.27; motor: 0.12, 95% CI; 0.07, 0.17; language: 0.21, 95% CI; 0.16, 0.25] and number of diarrhoeal episodes [cognitive: -2.87, 95% CI; -4.34, -1.39; motor: -2.62, 95% CI; -3.93, -1.29; language: -2.25, 95% CI; -3.32, -1.17] influenced the composite scores in all three domains i.e., cognitive, language and motor. While increase in LAZ score and stimulation led to increase in composite scores; an increase in number of diarrhoeal episodes was associated with decrease in scores. Weight for height z scores (WHZ) were associated with motor and language but not with cognitive scores. Additionally, a negative association of birth order with cognitive and language scores was noted. The findings indicate the possible importance of promoting nutrition and preventing diarrhoea as well as ensuring optimal stimulation and nurturance at home for enhancing child development in LBW infants.
Highlights
It is estimated that around 250 million (43%) children under the age of 5 years in low- and middle-income countries in 2010 did not reach their full developmental potential [1]
While increase in length for age z score (LAZ) score and stimulation led to increase in composite scores; an increase in number of diarrhoeal episodes was associated with decrease in scores
The findings indicate the possible importance of promoting nutrition and preventing diarrhoea as well as ensuring optimal stimulation and nurturance at home for enhancing child development in low birth weight (LBW) infants
Summary
It is estimated that around 250 million (43%) children under the age of 5 years in low- and middle-income countries in 2010 did not reach their full developmental potential [1]. It is important to identify factors that influence neurodevelopment in these low birth weight individuals especially in the first 2–3 years of life as this is the period when substantial brain development occurs [9,10]. It is important to examine whether the risk factors for poor neurodevelopment vary among normal healthy children and those born with low birth weight With this background, the primary objective of the current analysis was to determine the risk and protective factors for cognitive, language and motor performance in low birth weight infants from rural Haryana, India. It is important to determine factors that influence neurodevelopment in these low birth weight children especially in the first 2–3 years of life that represents a period of substantial brain development
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