Neurodevelopmental Status of Moderate to Late Preterm Infants at 6 Months Corrected Age

Background: Moderate Preterm (MP) and Late Preterm (LP) infants together comprise more than 80% of all prematurely born infants. Since last decade, there has been growing concern about Neurodevelopmental Abnormality (NDA) in these infants. This study was aimed to assess neurodevelopmental status of moderate to late preterm born neonates and to determine factors associated with adverse neurodevelopmental outcome in a tertiary hospital in Bangladesh. Materials and methods: In this prospective observational study 215 preterm (32 to <37 completed weeks gestation at birth) infants (107 MP and 108 LP) were enrolled from the Special Care Neonatal Unit (SCANU) Chittagong Medical College Hospital from June 2018 to May 2019. Neurodevelopmental assessment was done by Rapid Neurodevelopmental Assessment (RNDA) at 1, 3 and 6 months of Corrected Age (CA). Results: Of the 215 enrolled children, 63 (29.3%) attended all the 3 follow-up, 123 (57.2%) had incomplete follow-up or lost and 29 (13.5%) died. At final follow-up out of 63 infants 43 (68.3%) had no abnormality in all 8 domains of RNDA. Seven infants (11.1%) had abnormality in one domain and 13 (20.6%) had abnormality in more than one domain. Gross motor abnormality was most common abnormality (28.6%), followed by cognition (14.3%), vision (12.7%) and behavior (12.7%). Small for gestational age and lower birth weight were found to be independent predictive factors for NDA in moderate to late preterm infants. Conclusion: Study has shown that NDA persist till 6 months of CA in moderate to late preterm infants. It is important to closely monitor the neurodevelopmental status and provide early intervention in referred cases. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 50-54

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Intermittent Kangaroo Mother Care and the Practice of Breastfeeding Late Preterm Infants: Results from Four Hospitals in Different Provinces of China

10.21203/rs.2.18645/v2 ◽

2020 ◽

Author(s):

Bo Zhang ◽

Zhiying Duan ◽

Yingxi Zhao ◽

Sarah Williams ◽

Stephen Wall ◽

...

Keyword(s):

Breast Milk ◽

Preterm Infants ◽

Exclusive Breastfeeding ◽

Kangaroo Mother Care ◽

Late Preterm ◽

Feeding Practice ◽

Late Preterm Infants ◽

Breastfeeding Rate ◽

Milk Feeding

Abstract Background China has an extremely low exclusive breastfeeding rate. Kangaroo mother care (KMC) has been shown to increase the exclusive breastfeeding rate among infants born extremely or very preterm. However, there is limited evidence surrounding intermittent KMC and exclusive breastfeeding in late preterm infants. In our study we investigated the association between the provision of intermittent KMC and breastfeeding practice for late preterm infants in four hospitals in different provinces of China. Methods Intermittent KMC was recommended to the mothers of all preterm infants admitted to the postnatal wards of participating hospitals between March 2018 and March 2019. Those who agreed to practice KMC were enrolled in the “KMC group”, those who did not were enrolled in the “No KMC group”. Basic maternal socio-demographic information was collected, feeding practice; outcome and method, were recorded daily whilst in hospital. A follow-up survey of feeding practice was conducted 42 days after discharge. Calculations for feeding practice were performed separately for both groups. Logistics regression was used to analyze the association between KMC and feeding outcome and method, adjusting for socio-demographic covariates. Results Among the 844 mothers participating in the study, 627 (74.3%) chose to perform KMC. More of the mothers who provided KMC were exclusively breast milk feeding their infants in the 24 hours before hospital discharge (54.6%) and at follow-up (57.3%), compared to mothers who did not provide KMC (34.6% at discharge and 33.2% at follow-up,). Mothers in the KMC group were more likely to be breastfeeding (method) than mothers in the No KMC group (65.3% vs. 52.1% at discharge, and 83.1% vs. 67.3% at follow up). Logistic regression indicated that compared with the No KMC group, mothers who provided KMC were twice as likely to be exclusively breast milk feeding their infants at discharge (OR=2.15 (1.53-3.02)), use breastfeeding method at discharge as opposed to other means such as bottle or cup feeding (OR=1.61 (1.15-2.25)), be exclusive breast milk feeding at follow-up (OR=2.55 (1.81-3.61)), and use breastfeeding method at follow-up (OR=2.09 (1.44-3.02)). Conclusions Intermittent KMC was associated with a nearly doubled increase in exclusive breast milk feeding (outcome) and breastfeeding (method) at both discharge and 42 days after discharge for late preterm infants. This is especially important in China where exclusive breastfeeding rates are low, intermittent KMC provides a feasible means to increase the likelihood of these vulnerable infants receiving the benefits of exclusive breastmilk.

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