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

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...

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Published in:Journal of Health, Population & Nutrition Vol. 40; no. 1; pp. 1 - 11
Main Authors: Darmstadt, Gary L., Khan, Naila Z., Rosenstock, Summer, Muslima, Humaira, Parveen, Monowara, Mahmood, Wajeeha, Ahmed, A. S. M. Nawshad Uddin, Chowdhury, M. A. K. Azad, Zeger, Scott, Saha, Samir K.
Format: research Journal Article
Published: BioMed Central 5/26/2021
Online Access:View this record in EBSCOhost
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      dt: 5/26/2021
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      pub: BioMed Central
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        10.1186/s41043-021-00248-9
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        atl: Impact of emollient therapy for preterm infants in the neonatal period on child neurodevelopment in Bangladesh: an observational cohort study.
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        au:
          Darmstadt, Gary L.
          Khan, Naila Z.
          Rosenstock, Summer
          Muslima, Humaira
          Parveen, Monowara
          Mahmood, Wajeeha
          Ahmed, A. S. M. Nawshad Uddin
          Chowdhury, M. A. K. Azad
          Zeger, Scott
          Saha, Samir K.
        affil: Prematurity Research Center, Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, 1701 Page Mill Road, 94304, Palo Alto, CA, USA
      sug:
        subj:
          Emollients Therapeutic Use
          Infant, Premature
          Infant, Newborn
          Infant, Very Low Birth Weight
          Child, Preschool
          Prospective Studies
          Child
          Infant
          Bangladesh
          Child Development
          Human
          Comparative Studies
          Multicenter Studies
          Evaluation Research
          Validation Studies
          Scales
          Infant, Newborn: birth-1 month
          Child, Preschool: 2-5 years
          Child: 6-12 years
          Infant: 1-23 months
      ab: 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.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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