SEARCHCROSS-SECTIONALpediatrics, public health

cross-sectional·pediatrics, public health, epidemiology, neurology, observational study·PMC10476111

Growth and neurodevelopmental outcomes of preterm and low birth weight infants in rural Kenya: a cross-sectional study

BMJ Open · 7 authors, 6 centres

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TL;DR

This cross-sectional study assessed 362 preterm or low birth weight infants in rural Kenya at 6, 12, or 18 months of age.

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Participants were assessed at 6, 12, or 18 months of adjusted age using caregiver interviews, anthropometric measurements, and standardized neurodevelopmental tools. Direct measurement revealed higher proportions of stunting and underweight than national averages, while fewer than 2% of parents identified their child as malnourished. Neurodevelopmental delays were identified in 8.6% of infants, with 1.9% showing neurological findings indicative of cerebral palsy. Limitations include the lack of term-birth controls, potential selection bias (analyzed sample was 47.6% of eligible infants), and constraints from a national health worker strike.

STUDY TYPE

cross-sectional

SPECIALTY

pediatrics

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100% · A

ORIGINAL PAPER

PMC10476111

Growth and neurodevelopmental outcomes of preterm and low birth weight infants in rural Kenya: a cross-sectional study

BMJ Open

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ABSTRACT

Objective Data on long-term outcomes of preterm (PT) and low birth weight (LBW) infants in countries with high rates of neonatal mortality and childhood stunting are limited, especially from community settings. The current study sought to explore growth and neurodevelopmental outcomes of PT/LBW infants from a rural community-based setting of Kenya up to 18 months adjusted age. Design Cross-sectional study. Setting Migori County, Kenya. Participants Three hundred and eighty-two PT/LBW infants (50.2% of those identified as eligible) from a cluster randomised control trial evaluating a package of facility-based intrapartum quality of care interventions for newborn survival consented for follow-up. Outcome measures Caregiver interviews and infant health, growth and neurodevelopmental assessments were completed at 6, 12 or 18 months±2 weeks. Data included sociodemographic information, medical history, growth measurements and neurodevelopmental assessment using the Ten Questions Questionnaire, Malawi Developmental Assessment Tool and Hammersmith Infant Neurological Examination. Analyses were descriptive and univariate regression models. No alterations were made to planned data collection. Results The final sample included 362 PT/LBW infants, of which 56.6% were moderate to late PT infants and 64.4% were LBW. Fewer than 2% of parents identified their child as currently malnourished, but direct measurement revealed higher proportions of stunting and underweight than in national demographic and health survey reports. Overall, 22.7% of caregivers expressed concern about their child’s neurodevelopmental status. Neurodevelopmental delays were identified in 8.6% of infants based on one or more standardised tools, and 1.9% showed neurological findings indicative of cerebral palsy. Conclusions Malnutrition and neurodevelopmental delays are common among PT/LBW infants in this setting. Close monitoring and access to early intervention programmes are needed to help these vulnerable infants thrive. Trial registration number NCT03112018 .

CITATION EXPORT

Susanne P Martin-Herz, Phelgona Otieno, Grace M Laanoi et al.. Growth and neurodevelopmental outcomes of preterm and low birth weight infants in rural Kenya: a cross-sectional study. BMJ Open. (2023). https://doi.org/10.1136/bmjopen-2022-064678

AUTHORS

7 · 6 CENTRES

Susanne P Martin-Herz, Phelgona Otieno, Grace M Laanoi, Vincent Moshi, Geofrey Olieng’o Okoth, Nicole Santos, Dilys Walker

1Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
2Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
3Department of Paediatrics and Child Health, Maseno University, Maseno, Kenya
4Paediatric & Child Health, Jaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu, Kenya
5Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA
6Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, San Francisco, California, USA