Development In Low Birth Weight Infants Research Articles

Early child stimulation, linear growth and neurodevelopment in low birth weight infants

BackgroundChildren with low birth weight (LBW) are at risk of linear growth faltering and developmental deficits. Evidence suggests that early child stimulation and care reflected as responsive caregiving and opportunities for learning can promote development. The current analysis aimed to measure the extent to which linear growth and early child stimulation modify each other’s association with neurodevelopmental outcomes among LBW infants.MethodsThis is a secondary data analyses from a randomized controlled trial on the effect of community-initiated kangaroo mother care in LBW infants on their neurodevelopment at 12 months of corrected age. Bayley Scales of Infant and Toddler Development was used to assess cognitive, motor and language scores. Stimulation at home was assessed by the Pediatric Review of Children’s Environmental Support and Stimulation (PROCESS) tool. PROCESS scores were categorized into three groups: < Mean-1SD (low stimulation); Mean ± 1 SD (moderate stimulation) and > mean + 1SD (high stimulation).ResultsA total of 516 infants were available for neurodevelopment assessments. Interactions were observed between length for age z-score (LAZ) and PROCESS score categories. In the low stimulation group, the adjusted regression coefficients for the association between LAZ and cognitive, motor and language scores were substantially higher than in the moderate and high stimulation group. Stimulation was positively associated with neurodevelopmental outcomes in both stunted and non-stunted infants; however, the association was twice as strong in stunted than in non-stunted.ConclusionModerate to high quality stimulation may alleviate the risk of sub-optimal development in LBW infants with linear growth deficits.Clinical trial registrationThe primary trial whose data are analysed is registered at clinicaltrials.gov (https://clinicaltrials.gov/ct2/show/NCT02631343).

Pontine and Cerebellar Development in Low-Birthweight Infants at Term-Equivalent Age

Purpose: Pontine and cerebellar developments were investigated in low-birthweight (LBW) infants at term-equivalent age (TEA) using magnetic resonance imaging (MRI). Methods and Materials: The study subjects were a consecutive series of LBW infants born with a birthweight of &lt;1,500 g. Among them, 51 neonates with an extremely low birthweight (ELBW) and 65 neonates with a very low birthweight (VLBW) infants underwent MRI exam at TEA. We measured the pontine anteroposterior diameter (APD), cerebellar vermian APD and height, and cerebellar transverse width using midline sagittal and axial T1 weighted images. Twenty term neonates with neonatal asphyxia showing a normal pattern and white matter injury on MRI exam served as a control group. Gender differences in these parameters were compared among the LBW groups. Result: Pontine APD in the ELBW group was significantly less than that in the control group. Cerebellar vermian APD and height were similar among the 3 groups. However, cerebellar transverse width was significantly less in the LBW groups than in the control group. A significant gender-related difference in pontine APD was evident, but cerebellar measurements showed no significant gender difference. Conclusion: LBW infants showed significantly developmental delay in terms of pontine APD and cerebellar width. A sex difference in pontine growth was evident among LBW infants.

Association between General Movements Assessment and Later Motor Delay (excluding Cerebral Palsy) in Low-Birth-Weight Infants.

The general movements (GMs) assessment is useful for the prediction of cerebral palsy (CP) and other developmental disorders. Developmental coordination disorder (DCD) is highly prevalent in low-birth-weight (LBW) infants. We investigated the association between aberrant GMs during early infancy and later motor development in LBW infants. The study included infants who fulfilled the following criteria: GMs assessed at 9–20 weeks post-term age; developmental quotient (DQ) assessed at 3 years of age using the Kyoto Scale; intelligence quotient (IQ) assessed at 6 years of age. Participants with normal IQs at 6 years of age without a diagnosis of CP (14 males and 37 females, 23–36 weeks gestation with birth weights of 492–1498 g) were categorized into normal (n = 39) and aberrant (n = 12) groups based on GMs assessment; DQ was compared between the groups. We investigated the items in the DQ assessment and found that the infants in the aberrant group were more frequently unable to perform. Infants in the aberrant group showed a significantly lower DQ in the ‘postural-motor domain’, and were more frequently unable to ‘climb the stairs with alternating legs’ and ‘Jump from a 15–20 cm platform’. This study highlights that GMs aberrancy in early infancy is associated with a delayed gross motor development, even in children with a typical development. The GMs assessment may be useful for the prediction of DCD.

Evaluation of the social skills of low birthweight infants using the Interaction Rating Scale.

[Purpose] This study aimed to examine, using the Interaction Rating Scale, the effect of social skills at 18 months of life on the subsequent development of low birthweight infants. [Participants and Methods] The study participants were made up of a total of 23 infants who were admitted to the neonatal intensive care unit of Hospital A and whose developmental indexes were followed up at the outpatient clinic for up to 3 years of age. The survey was conducted twice in each infant, at a corrected age of 18 months and at 36 full months of age. Social skills and developmental indexes were assessed at the corrected age of 18 months, meanwhile only developmental indexes were assessed at 36 full months, to examine associations. The Interaction Rating Scale was used to assess social skills. This scale measures various aspects of social development by observing caregiver-child interactions in situations wherein children are engaged in tasks more difficult for their age. [Results] The results demonstrated that social skills at 18 months were associated with the developmental indexes at 18 and 36 months, whereas more items were associated with the developmental index at 36 months. [Conclusion] The results indicate the need for early prediction of developmental delay and timely intervention, by assessing social skills in low birthweight infants.

Factors determining cognitive, motor and language scores in low birth weight infants from North India.

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.

Use of Coconut Oil Massage versus Olive Oil Massage on Selected Physical and Physiological Parameters among Low Birth Weight Newborns in Selected Hospitals, in West Bengal

The most significant contributing factor of neonatal mortality and morbidity is low birth weight (LBW). Oil massage helps in growth and development in LBW infants. The purpose of the study is to evaluate the effectiveness of coconut oil versus olive oil massage on selected physical and physiological parameters among LBW newborns. Ethical permission was taken. The study design is quasi experimental time series design. 30 LBW newborns (10 in coconut, 10 in olive & 10 in control group) were selected by non-probability purposive sampling. Data were collected from NICU by using valid and reliable Record Analysis, Physical Assessment, Modified Brazelton’s Scale and Maturity Assessment Scale. 10 ml /kg/day oil applied once only for 15 minutes upto 28th day. Weight, length, head and chest circumference, sleep, cry and maturity were assessed on 8th, 15th, 22nd and 29th day for each newborn. The result showed that there were no significant difference in physical parameters on 29th day of observation among three groups except weight gain (F=8.70, p=0.001207). There were significant difference in all post assessments of sleep. There were significant difference in cry score on 15th day (p=0.007701) and 22nd day (p=0.000758) of observation. Statistically significant differences were not found in all assessment of maturity. It can be concluded that oil massage has positive effect, compared to control. The study has a great implication in nursing service by practicing oil massage helps to gain weight and improve behaviour among LBW newborns. A similar study could be conducted using large sample for generalization.

Effect of early nursing intervention on promoting physical and mental development of premature low birth weight infants

Objective To explore the effects of early care intervention on promoting physical and mental development in premature low birth weight infants. Methods A total of 78 cases of preterm low birth weight infants in Shandong Provincial Hospital Affiliated to Shandong University from January to August 2016 were selected by random number table method, and randomly divided into control group and observation group, with 39 cases in each group. The control group was given routine neonatology nursing, while the observation group was given early care intervention on the basis of control group. The intelligence development status of the two groups was evaluated after intervention, and the height and weight of the children were measured. Results There were significant differences in intelligence development index, motor development index, sensory development index, height and weight between the two groups after intervention (P<0.05) . Conclusions Early care intervention is helpful to the physical and intellectual development of premature low birth weight infants, can better improve the prognosis of children, and promote their healthy growth. Key words: Infant, premature; Low birth weight infants; Early care intervention; Intelligence; Physical development

Effects evaluation of transitional care intervention on development of preterm low birth weight infants

Objective To study on the effects of transitional care intervention on preterm low birth weight infant′s development. Methods A total of 50 cases of survived preterm low birth weight infants (PLBW) were selected as experimental group from March to October 2013 and 53 cases as control group with the same period in 2012. The patients of experimental group received transitional care intervention. In control group, infants just received routine health examination and child care. At the corrected age 6months and 12months, all infants in the two groups received height and weight tests and intelligent test. Results The average scores of 6 months corrected age PLBI weight and height were (7.43±0.36)kg, (67.32±1.85)cm in the experimental group and (6.37±0.29)kg, (63.72±2.06)cm in the control group (t=16.50, 9.31; P<0.01), while these of 12 months corrected age PLBI were (9.17±0.78)kg and (75.14±2.78)cm in the experimental group and (7.84±0.89)kg and (69.93±2.92)cm (t=8.04, 9.26; P<0.01). At the corrected age 6 months, the infants′ adaptive behavior, movement, fine motor, language and social DQ in the experimental group were better than these of the control group (t=5.09, 3.46, 7.14, 7.37, 7.70; P<0.01). At the corrected age 12 months, the infants′ adaptive behavior, movement, fine motor, language and social DQ in the experimental group were better than these of the control group (t=6.40, 7.59, 8.01, 5.36, 6.36; P<0.01). Conclusions The transitional care intervention can promote premature infants development, so as to improve their quality of life. Key words: Transitional care; Preterm low birth weight infant; Quality of life; Growth and development

Psychosocial Intervention Improves the Development of Term Low-Birth-Weight Infants

It is estimated that 11% of births in developing counties are term low-birth-weight (LBW); however, there is limited information on the development of these infants. Our objectives were to determine the effect of psychosocial intervention on the development of LBW infants and to compare term LBW and normal-birth-weight (NBW) infants. Term LBW (n = 140) and NBW infants (n = 94) were enrolled from the main maternity hospital in Kingston, Jamaica. The LBW infants were randomly assigned to control or intervention comprising weekly home visits from birth to 8 wk and from 7 to 24 mo of age. Development was assessed at 15 and 24 mo with the Griffiths Scales. The intervention benefited the infants' developmental quotient (DQ, P < 0.05) and performance subscale at 15 mo (P < 0.02), the hand and eye (P < 0.05) and performance subscales (P < 0.02) at 24 mo, and home environment at 12 mo. The effect of the intervention on development was mediated in part by the improvement in the home environment. The control LBW infants had significantly lower scores than the NBW in DQ and several subscales, whereas there were no significant differences between the NBW and the LBW infants after intervention. In conclusion, term LBW was associated with developmental delays, which were reduced with psychosocial intervention.

Development of low-birthweight infants at 19 months of age correlates with early intake and status of long-chain polyunsaturated fatty acids

We investigated the influence of early nutrition with and without long-chain polyunsaturated fatty acids (LCP) on later development of ≦2500 g newborns receiving preterm formula without LCP (n=75), preterm formula with 18:3ω6 and LCPω3 (at two doses;n=26) or their mother's own milk (n=27). All diets were given from birth to day 42. Erythrocytes (RBC) fatty-acid compositions were determined on day 42. Bayley's mental development (MDI) and psychomotor development (PDI) indices were assessed at 19 months. Multivariate regression analysis revealed that PDI was most strongly related to RBC 22:6 ω 3 in the cohort of 101 infants who received formula. The most consistent correlations were between development and early LCPω3 intake, and between development and parameters of RBC LCPω3 status day 42, in infants who received formula with 18:3ω6 and LCPω3. Development of formula-fed low-birthweight infants seems positively influenced by early dietary LCPω3.

Effects of maternal intelligence, marital status, income, and home environment on cognitive development of low birthweight infants.

To examine direct and mediated effects of maternal IQ, marital status, family income, and quality of the home environment on the cognitive development of low birthweight infants. Secondary analyses on a large dataset using hierarchical regression identified factors correlated with cognitive outcomes in children at 3 years of age who were born at low birthweight. Maternal IQ was a critical variable, because it was highly correlated with child IQ and because maternal intelligence influenced patterns of relationships among other predictor variables including marital status, income level, and home environment on child IQ. Analyses revealed that effects of these variables on child IQ interacted with maternal IQ. Early childhood intervention programs should target those low birthweight infants most at risk for impaired cognitive development. Children at greatest risk are those living with unmarried, low IQ mothers.

Annotation: Supporting the Development of Low Birthweight Infants

Annotation: Supporting the Development of Low Birthweight Infants

The Early Development of Low-Birthweight Infants: Relationship to Health, Family Status, Family Context, Family Processes, and Parenting

This study examines the early development of low birthweight infants and its relationship to five categories of medical and environmental variables: (1) health; (2) family status; (3) family context; (4) family process; and (5) parenting. Results showed that scores on the Bayley Mental Development Index. (MDI) at 18 months were related to all five categories of variables. However, most correlations were only moderate in strength (0.3 to 0.5) and four of the. five categories could be represented by only a single variable within the category. Multiple regression analyses indicated that family context and family process variables were not as highly related to MDI as family status, medical problems, and parenting were. The most efficient prediction of MDI was obtained using a combination of two HOME subscales, variety of stimulation and organisation of the environment, plus the 5-minute APGAR (R = 0.59).

Early Growth and Development in Low-Birthweight Infants Following Treatment in an Intensive Care Nursery

Sixty-seven appropriate-for-date infants with gestations less than 33 weeks were followed for 12 months after their term dates. All had been born after September 1970. None received hypercaloric alimentation as neonates. Growth from the expected date of delivery was compared with that of 24 normal full-term infants and with accepted growth standards. The boys did not differ from the controls or the standard in mean weight, length, and head circumference, in weight and height indices, or in velocity of weight and linear growth. The girls had a slower velocity of weight growth for the first six months and had significantly lower weight indices at 12 months than did their controls. Velocity of linear growth, height indices, and mean length and head circumference for the girls were similar to those of the control standards. Gross central nervous system defects occurred in 22.5% of the boys but in none of the girls. More than one half of the abnormalities were hydrocephaly. The mean post-conceptional developmental quotient was 110 for the girls and 108 for the boys.