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Randomized Controlled Trial
. 2022 Oct 8;22(1):586.
doi: 10.1186/s12887-022-03579-6.

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

Ravi Prakash Upadhyay  1   2 , Sunita Taneja  3 , Tor A Strand  4 , Halvor Sommerfelt  5   6 , Mari Hysing  7 , Sarmila Mazumder  3 , Nita Bhandari  3 , Jose Martines  5 , Tarun Dua  8 , Patricia Kariger  9 , Rajiv Bahl  10
Affiliations
Randomized Controlled Trial

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

Ravi Prakash Upadhyay et al. BMC Pediatr. .

Abstract

Background: Children 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.

Methods: This 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).

Results: A 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.

Conclusion: Moderate to high quality stimulation may alleviate the risk of sub-optimal development in LBW infants with linear growth deficits.

Clinical trial registration: The primary trial whose data are analysed is registered at clinicaltrials.gov ( https://clinicaltrials.gov/ct2/show/NCT02631343 ).

Keywords: Child stimulation; Infancy; Linear growth; Low birth weight; Neurodevelopment.

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Conflict of interest statement

No competing interest to declare.

Figures

Fig. 1
Fig. 1
GAM plot depicting the relationship between length-for-age Z score, PROCESS score and cognitive, motor and language composite score
See this image and copyright information in PMC

References

    1. Fox SE, Levitt P, Nelson CA., 3rd How the timing and quality of early experiences influence the development of brain architecture. Child Dev. 2010;81(1):28–40. doi: 10.1111/j.1467-8624.2009.01380.x. - DOI - PMC - PubMed
    1. Wachs TD, Georgieff M, Cusick S, McEwen BS. Issues in the timing of integrated early interventions: contributions from nutrition, neuroscience, and psychological research. Ann N Y Acad Sci. 2014;1308:89–106. doi: 10.1111/nyas.12314. - DOI - PMC - PubMed
    1. Bick J, Nelson CA. Early adverse experiences and the developing brain. Neuropsychopharmacology. 2016;41(1):177–196. doi: 10.1038/npp.2015.252. - DOI - PMC - PubMed
    1. Upadhyay RP, Naik G, Choudhary TS, Chowdhury R, Taneja S, Bhandari N, et al. Cognitive and motor outcomes in children born low birth weight: a systematic review and meta-analysis of studies from South Asia. BMC Pediatr. 2019;19(1):35. doi: 10.1186/s12887-019-1408-8. - DOI - PMC - PubMed
    1. Arpi E, Ferrari F. Preterm birth and behaviour problems in infants and preschool-age children: a review of the recent literature. Dev Med Child Neurol. 2013;55(9):788–796. doi: 10.1111/dmcn.12142. - DOI - PubMed

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