Developmental Outcomes of Preterm and Low Birth Weight Toddlers and Term Peers in Rwanda
Background: As neonatal care improves in low-resource settings, more preterm or low birth weight (LBW) babies are surviving, but little is known about their long-term outcomes. Globally, preterm and/or LBW babies are at increased risk of mortality, malnutrition, and developmental delay. Objectives:...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Ubiquity Press
2019-12-01
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| Series: | Annals of Global Health |
| Online Access: | https://annalsofglobalhealth.org/articles/2629 |
| _version_ | 1818571646919770112 |
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| author | Alain Ahishakiye Marie Claire Abimana Kathryn Beck Ann C. Miller Theresa S. Betancourt Hema Magge Christine Mutaganzwa Catherine M. Kirk |
| author_facet | Alain Ahishakiye Marie Claire Abimana Kathryn Beck Ann C. Miller Theresa S. Betancourt Hema Magge Christine Mutaganzwa Catherine M. Kirk |
| author_sort | Alain Ahishakiye |
| collection | DOAJ |
| description | Background: As neonatal care improves in low-resource settings, more preterm or low birth weight (LBW) babies are surviving, but little is known about their long-term outcomes. Globally, preterm and/or LBW babies are at increased risk of mortality, malnutrition, and developmental delay. Objectives: We aim to describe the differences in development in rural Rwandan children at 24–36 months of age born preterm and/or LBW compared to their peers born term or normal birth weight (term/NBW), and to assess factors associated with poor development. Methods: We conducted a cross-sectional study using secondary data analysis from two combined datasets from 2014, using Ages and Stages Questionnaire (ASQ-3) for developmental assessment and anthropometrics for nutritional status (stunting and wasting). Demographic and clinical factors associated with poor developmental outcomes in univariate regression at α = 0.20 were included in a full model; we used backward stepwise penalized multivariable logistic regression to identify a final model at α = 0.05. Findings: In total, 445 children were included; 405 term/NBW, and 40 preterm and/or LBW. Half of them (n = 234; 52.6%) had developmental delay, including 207 (51.1%) among term/NBW and 27 (67.5%) among preterm and/or LBW (p = 0.048). In the final model, term/NBW children with stunting alone had a significant increase in the odds of developmental delay (OR 2.05, 95% CI 1.37–3.07), and children with wasting had a borderline statistically significant increased odds of developmental delay (OR 5.79, 95% CI 0.98-34.39). Being preterm and/or LBW and not stunted completely predicted delay. Conclusion: Half of the children had developmental delay in our sample from rural Rwanda. Preterm and/or LBW infants were more likely to have developmental delay, and the main predictor of developmental delay was stunting, with high rates of stunting observed also in term/NBW infants. Interventions to reduce undernutrition and prevent prematurity and LBW, alongside investments to promote early stimulation for optimal development, are needed if gains in addressing developmental delay are to be made. |
| first_indexed | 2024-12-14T13:58:47Z |
| format | Article |
| id | doaj.art-a31f946aca324f80888bdc219b8c7595 |
| institution | Directory Open Access Journal |
| issn | 2214-9996 |
| language | English |
| last_indexed | 2024-12-14T13:58:47Z |
| publishDate | 2019-12-01 |
| publisher | Ubiquity Press |
| record_format | Article |
| series | Annals of Global Health |
| spelling | doaj.art-a31f946aca324f80888bdc219b8c75952022-12-21T22:58:46ZengUbiquity PressAnnals of Global Health2214-99962019-12-0185110.5334/aogh.26292417Developmental Outcomes of Preterm and Low Birth Weight Toddlers and Term Peers in RwandaAlain Ahishakiye0Marie Claire Abimana1Kathryn Beck2Ann C. Miller3Theresa S. Betancourt4Hema Magge5Christine Mutaganzwa6Catherine M. Kirk7Rwinkwavu District Hospital, Ministry of Health, RwinkwavuPartners In Health/Inshuti Mu Buzima, RwinkwavuPartners In Health/Inshuti Mu Buzima, RwinkwavuDivision of Global Health and Social Medicine, Harvard Medical School, BostonSchool of Social Work, Boston College, BostonDivision of General Pediatrics, Boston Children’s Hospital, Boston, US; Institute of Health Care Improvement, Addis AbabaPartners In Health/Inshuti Mu Buzima, RwinkwavuPartners In Health/Inshuti Mu Buzima, RwinkwavuBackground: As neonatal care improves in low-resource settings, more preterm or low birth weight (LBW) babies are surviving, but little is known about their long-term outcomes. Globally, preterm and/or LBW babies are at increased risk of mortality, malnutrition, and developmental delay. Objectives: We aim to describe the differences in development in rural Rwandan children at 24–36 months of age born preterm and/or LBW compared to their peers born term or normal birth weight (term/NBW), and to assess factors associated with poor development. Methods: We conducted a cross-sectional study using secondary data analysis from two combined datasets from 2014, using Ages and Stages Questionnaire (ASQ-3) for developmental assessment and anthropometrics for nutritional status (stunting and wasting). Demographic and clinical factors associated with poor developmental outcomes in univariate regression at α = 0.20 were included in a full model; we used backward stepwise penalized multivariable logistic regression to identify a final model at α = 0.05. Findings: In total, 445 children were included; 405 term/NBW, and 40 preterm and/or LBW. Half of them (n = 234; 52.6%) had developmental delay, including 207 (51.1%) among term/NBW and 27 (67.5%) among preterm and/or LBW (p = 0.048). In the final model, term/NBW children with stunting alone had a significant increase in the odds of developmental delay (OR 2.05, 95% CI 1.37–3.07), and children with wasting had a borderline statistically significant increased odds of developmental delay (OR 5.79, 95% CI 0.98-34.39). Being preterm and/or LBW and not stunted completely predicted delay. Conclusion: Half of the children had developmental delay in our sample from rural Rwanda. Preterm and/or LBW infants were more likely to have developmental delay, and the main predictor of developmental delay was stunting, with high rates of stunting observed also in term/NBW infants. Interventions to reduce undernutrition and prevent prematurity and LBW, alongside investments to promote early stimulation for optimal development, are needed if gains in addressing developmental delay are to be made.https://annalsofglobalhealth.org/articles/2629 |
| spellingShingle | Alain Ahishakiye Marie Claire Abimana Kathryn Beck Ann C. Miller Theresa S. Betancourt Hema Magge Christine Mutaganzwa Catherine M. Kirk Developmental Outcomes of Preterm and Low Birth Weight Toddlers and Term Peers in Rwanda Annals of Global Health |
| title | Developmental Outcomes of Preterm and Low Birth Weight Toddlers and Term Peers in Rwanda |
| title_full | Developmental Outcomes of Preterm and Low Birth Weight Toddlers and Term Peers in Rwanda |
| title_fullStr | Developmental Outcomes of Preterm and Low Birth Weight Toddlers and Term Peers in Rwanda |
| title_full_unstemmed | Developmental Outcomes of Preterm and Low Birth Weight Toddlers and Term Peers in Rwanda |
| title_short | Developmental Outcomes of Preterm and Low Birth Weight Toddlers and Term Peers in Rwanda |
| title_sort | developmental outcomes of preterm and low birth weight toddlers and term peers in rwanda |
| url | https://annalsofglobalhealth.org/articles/2629 |
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