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Observational Study
. 2021 May 26;40(1):24.
doi: 10.1186/s41043-021-00248-9.

Impact of emollient therapy for preterm infants in the neonatal period on child neurodevelopment in Bangladesh: an observational cohort study

Gary L Darmstadt  1 , Naila Z Khan  2 , Summer Rosenstock  3 , Humaira Muslima  2 , Monowara Parveen  2 , Wajeeha Mahmood  4 , A S M Nawshad Uddin Ahmed  5 , M A K Azad Chowdhury  5 , Scott Zeger  6 , Samir K Saha  7   8
Affiliations
Observational Study

Impact of emollient therapy for preterm infants in the neonatal period on child neurodevelopment in Bangladesh: an observational cohort study

Gary L Darmstadt et al. J Health Popul Nutr. .

Abstract

Background: Topical treatment with sunflower seed oil (SSO) or Aquaphor® reduced sepsis and neonatal mortality in hospitalized preterm infants <33 weeks' gestational age in Bangladesh. We sought to determine whether the emollient treatments improved neurodevelopmental outcomes during early childhood.

Methods: 497 infants were randomized to receive SSO, Aquaphor®, or neither through the neonatal period or hospital discharge. 159 infant survivors were enrolled in the longitudinal follow-up study using a validated Rapid Neurodevelopmental Assessment tool and the Bayley Scales of Infant Development II (BSID II) administered at three-monthly intervals for the first year and thereafter at six-monthly intervals. Lowess smoothing was used to display neurodevelopmental status across multiple domains by age and treatment group, and Generalized Estimating Equations (GEE) were used to compare treatment groups across age points.

Results: 123 children completed at least one follow-up visit. Lowess graphs suggest that lower proportions of children who received massage with either SSO or Aquaphor® had neurodevelopmental delays than control infants in a composite outcome of disabilities. In GEE analysis, infants receiving SSO showed a significant protective effect on the development of fine motor skills [odds ratio (OR) 0.92, 95% confidence interval (CI) 0.86-0.98, p=0.006]. The Psychomotor Development Index (PDI) in the BSID II showed significantly lower disability rates in the Aquaphor group (23.6%) compared to the control (55.2%) (OR 0.21, 95% CI 0.06-0.72, p=0.004).

Conclusions: Emollient massage of very preterm, hospitalized newborn infants improved some child neurodevelopmental outcomes over the first 2 years of follow-up. Findings warrant further confirmatory research.

Trial registration: ClinicalTrials.gov (98-04-21-03-2) under weblink https://clinicaltrials.gov/ct2/show/NCT00162747.

Keywords: Emollient; Follow-up; Neonatal; Neurodevelopment; Newborn; Preterm.

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Conflict of interest statement

The authors have indicated they have no potential conflicts of interest to disclose. The authors have indicated they have no financial relationships relevant to this article to disclose.

Figures

Fig. 1
Fig. 1
Lowess graphs of disability probability for preterm infants followed-up during early childhood in Bangladesh. a Probability of any disability. b Probability of cognitive disability. c Probability of fine motor disability. d Probability of hearing disability. e Probability of speech disability
See this image and copyright information in PMC

References

    1. Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, Cousens S, Mathers C, Black RE. Global, regional, and national causes of child mortality in 2000-13, with projections to inform post-2015 priorities: an updated systematic analysis. Lancet. 2015;385(9966):430–440. doi: 10.1016/S0140-6736(14)61698-6. - DOI - PubMed
    1. Dammann O, Leviton A, Gappa M, Dammann CE. Lung and brain damage in preterm newborns, and their association with gestational age, prematurity subgroup, infection/inflammation and long term outcome. BJOG. 2005;112(Suppl 1):4–9. doi: 10.1111/j.1471-0528.2005.00576.x. - DOI - PubMed
    1. Stjernqvist K, Svenningsen NW. Ten-year follow-up of children born before 29 gestational weeks: health, cognitive development, behavior and school achievement. Acta Paediatr. 1999;88(5):557–562. doi: 10.1111/j.1651-2227.1999.tb00175.x. - DOI - PubMed
    1. Wolke D, Meyer R. Cognitive status, language attainment, and prereading skills of 6-year-old very preterm children and their peers: the Bavarian Longitudinal Study. Dev Med Child Neurol. 1999;4:94–109. doi: 10.1017/S0012162299000201. - DOI - PubMed
    1. Taylor H, Klein N, Minich N, Hack M. Middle-school-age outcomes in children with very low birth weight. Child Dev. 2000;71:1495–1511. doi: 10.1111/1467-8624.00242. - DOI - PubMed

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