Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Pediatrics
Published in: BMC Pediatrics 1/2019

Open Access 01-12-2019 | Research article

Cognitive and motor outcomes in children born low birth weight: a systematic review and meta-analysis of studies from South Asia

Authors: Ravi Prakash Upadhyay, Gitismita Naik, Tarun Shankar Choudhary, Ranadip Chowdhury, Sunita Taneja, Nita Bhandari, Jose Carlos Martines, Rajiv Bahl, Maharaj Kishan Bhan

Published in: BMC Pediatrics | Issue 1/2019

Login to get access

Abstract

Background

South Asia contributes substantially to global low birth weight population (i.e. those with birth weight < 2500 g). Synthesized evidence is lacking on magnitude of cognitive and motor deficits in low birth weight (LBW) children compared to those with normal birth weight (NBW) (i.e. birth weight ≥ 2500 g). The meta-analysis aimed to generate this essential evidence.

Methods

Literature search was performed using PubMed and Google Scholar. Original research articles from south Asia that compared cognitive and/or motor scores among LBW and NBW individuals were included. Weighted mean differences (WMD) and pooled relative risks (RR) were calculated. All analyses were done using STATA 14 software.

Results

Nineteen articles (n = 5999) were included in the analysis. Children < 10 years of age born LBW had lower cognitive (WMD -4.56; 95% CI: -6.38, − 2.74) and motor scores (WMD -4.16; 95% CI: -5.42, − 2.89) compared to children with NBW. Within LBW children, those with birth weight < 2000 g had much lower cognitive (WMD -7.23, 95% CI; − 9.20, − 5.26) and motor scores (WMD -6.45, 95% CI; − 9.64, − 3.27).

Conclusions

In south Asia, children born LBW, especially with < 2000 g birth weight, have substantial cognitive and motor impairment compared to children with NBW. Early child development interventions should lay emphasis to children born LBW.
Appendix
Available only for authorised users
Literature
1.
2.
Lee AC, Katz J, Blencowe H, Kozuki N, Vogel JP, Adair L, et al. National and regional estimates of term and preterm babies born small for gestational age in 138 low-income and middle-income countries in 2010. Lancet Glob Health. 2013;1(1):e26–36.CrossRef
3.
4.
Christian P, Lee SE, Donahue Angel M, Adair LS, Arifeen SE, Ashorn P, et al. Risk of childhood undernutrition related to small-for-gestational age and preterm birth in low- and middle-income countries. Int J Epidemiol. 2013;42(5):1340–55.CrossRef
5.
Hviid A, Melbye M. The impact of birth weight on infectious disease hospitalization in childhood. Am J Epidemiol. 2007;165(7):756–61.CrossRef
6.
Million Death Study Collaborators, Bassani DG, Kumar R, Awasthi S, Morris SK, Paul VK, et al. Causes of neonatal and child mortality in India: a nationally representative mortality survey. Lancet. 2010;376(9755):1853–60.CrossRef
7.
Veena SR, Krishnaveni GV, Wills AK, Kurpad AV, Muthayya S, Hill JC, et al. Association of birthweight and head circumference at birth to cognitive performance in 9-to 10-year-old children in South India: prospective birth cohort study. Pediatr Res. 2010;67:424–9.CrossRef
8.
Danaei G, Andrews KG, Sudfeld CR, Fink G, McCoy DC, Peet E, et al. Risk factors for childhood stunting in 137 developing countries: a comparative risk assessment analysis at global, regional, and country levels. PLoS Med. 2016;13(11):e1002164.CrossRef
9.
Suzuki K. The developing world of DOHaD. J Dev Orig Health Dis. 2018;9(3):266–9.CrossRef
10.
Luyckx VA, Perico N, Somaschini M, Manfellotto D, Valensise H, Cetin I, et al. A developmental approach to the prevention of hypertension and kidney disease: a report from the low birth weight and nephron number working group. Lancet. 2017;390(10092):424–8.CrossRef
11.
Gogia S, Sachdev HP. Home-based neonatal care by community health workers for preventing mortality in neonates in low- and middle-income countries: a systematic review. J Perinatol. 2016;36(Suppl 1):S55–73.CrossRef
12.
Nair N, Tripathy P, Prost A, Costello A, Osrin D. Improving newborn survival in low-income countries: community-based approaches and lessons from South Asia. PLoS Med. 2010;7(4):e1000246.CrossRef
13.
Orchinik LJ, Taylor HG, Espy KA, Minich N, Klein N, Sheffield T, et al. Cognitive outcomes for extremely preterm/extremely low birth weight children in kindergarten. J Int Neuropsychol Soc. 2011;17(6):1067–79.CrossRef
14.
Weindrich D, Jennen-Steinmetz C, Laucht M, Schmidt MH. Late sequelae of low birthweight: mediators of poor school performance at 11 years. Dev Med Child Neurol. 2003;45(7):463–9.CrossRef
15.
Whitaker AH, Feldman JF, Lorenz JM, Shen S, McNicholas F, Nieto M, et al. Motor and cognitive outcomes in nondisabled low-birth-weight adolescents: early determinants. Arch Pediatr Adolesc Med. 2006;160(10):1040–6.CrossRef
16.
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):788–96.CrossRef
17.
Leijon I, Ingemansson F, Nelson N, Wadsby M, Samuelsson S. Reading deficits in very low birthweight children are associated with vocabulary and attention issues at the age of seven. Acta Paediatr. 2016;105(1):60–8.CrossRef
18.
Hayes B, Sharif F. Behavioural and emotional outcome of very low birth weight infants--literature review. J Matern Fetal Neonatal Med. 2009;22(10):849–56.CrossRef
19.
Miller SL, Huppi PS, Mallard C. The consequences of fetal growth restriction on brain structure and neurodevelopmental outcome. J Physiol. 2016;594(4):807–23.CrossRef
20.
Volpe JJ. Brain injury in premature infants: a complex amalgam of destructive and developmental disturbances. Lancet Neurol. 2009;8:110–24.CrossRef
21.
Bhutta AT, Cleves MA, Casey PH, Cradock MM, Anand KJ. Cognitive and behavioral outcomes of school-aged children who were born preterm: a meta-analysis. JAMA. 2002;288(6):728–37.CrossRef
22.
Blencowe H, Cousens S, Chou D, Oestergaard M, Moller AB, Say L, et al. Born too soon: the global epidemiology of 15 million preterm births. Reprod Health. 2013;10(Suppl 1):S2.CrossRef
23.
24.
25.
26.
27.
Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol. 2005;5:13.CrossRef
28.
Furukawa TA, Barbui C, Cipriani A, Brambilla P, Watanabe N. Imputing missing standard deviations in meta-analyses can provide accurate results. J Clin Epidemiol. 2006;59(1):7–10.CrossRef
29.
30.
Chaudhari S, Bhalerao MR, Chitale A, Pandit AN, Nene U. Pune low birth weight study--a six year follow up. Indian Pediatr. 1999;36(7):669–76.PubMed
31.
Tandon A, Kumari S, Ramji S, Malik A, Singh S, Nigam VR. Intellectual psycho-educational and functional status of low birth weight survivors beyond 5 years of age. Indian J Pediatr. 2000;67(11):791–6.CrossRef
32.
Chaudhari S, Otiv M, Chitale A, Pandit A, Hoge M. Pune low birth weight study--cognitive abilities and educational performance at twelve years. Indian Pediatr. 2004;41(2):121–8.PubMed
33.
Juneja M, Shankar A, Ramji S. Neurodevelopmental, functional and growth status of term low birth weight infants at eighteen months. Indian Pediatr. 2005;42(11):1134–40.PubMed
34.
Taneja S, Bhandari N, Bahl R, Bhan MK. Impact of zinc supplementation on mental and psychomotor scores of children aged 12 to 18 months: a randomized, double-blind trial. J Pediatr. 2005;146(4):506–11.CrossRef
35.
36.
Nair MK, Chacko DS, Paul MK, Nair L, George B, Kumar GS. Low birthweight babies--outcome at 13 years. Indian Pediatr. 2009;46(Suppl):s71–4.PubMed
37.
Sidhu M, Malhi P, Jerath J. Multiple risks and early language development. Indian J Pediatr. 2010;77(4):391–5.CrossRef
38.
Hoque MM, Ahmed NU, Khan FH, Jahan R, Yasmeen HN, Chowdhury MA. Breastfeeding and cognitive development of children: assessment at one year of age. Mymensingh Med J. 2012;21(2):316–21.PubMed
39.
Khan MR, Maheshwari PK, Shamim H, Saleem AF, Ahmed S, Ali SR, et al. Neurodevelopmental outcomes of premature infants at a tertiary care center in Pakistan. Pediatr Neurol. 2012;47(2):109–13.CrossRef
40.
Tofail F, Hamadani JD, Ahmed AZ, Mehrin F, Hakim M, Huda SN. The mental development and behavior of low-birth-weight Bangladeshi infants from an urban low-income community. Eur J Clin Nutr. 2012;66(2):237–43.CrossRef
41.
Modi M, Saluja S, Kler N, Batra A, Kaur A, Garg P, et al. Growth and neurodevelopmental outcome of VLBW infants at 1 year corrected age. Indian Pediatr. 2013;50(6):573–7.CrossRef
42.
Chaudhari S, Otiv M, Khairnar B, Pandit A, Hoge M, Sayyad M. Pune low birth weight study - birth to adulthood - cognitive development. Indian Pediatr. 2013;50(9):853–7.CrossRef
43.
Avan BI, Raza SA, Kirkwood BR. An epidemiological study of urban and rural children in Pakistan: examining the relationship between delayed psychomotor development, low birth weight and postnatal growth failure. Trans R Soc Trop Med Hyg. 2015;109(3):189–96.CrossRef
44.
Nair MK, Krishnan R, Harikumaran Nair GS, George B, Bhaskaran D, Leena ML, et al. CDC Kerala 3: at-risk baby clinic service using different screening tools--outcome at 12 months using developmental assessment scale for Indian infants. Indian J Pediatr. 2014;81(Suppl 2):S80–4.CrossRef
45.
Christian P, Murray-Kolb LE, Tielsch JM, Katz J, LeClerq SC, Khatry SK. Associations between preterm birth, small-for-gestational age, and neonatal morbidity and cognitive function among school-age children in Nepal. BMC Pediatr. 2014;14:58.CrossRef
46.
Chattopadhyay N, Mitra K. Neurodevelopmental outcome of high risk newborns discharged from special care baby units in a rural district in India. J Public Health Res. 2015;4(1):318.CrossRef
47.
Singh A, Roy N, Boro P. A community based cross sectional study on developmental delay and its determinants amongst under two year old children in an Urbanized Village of Delhi. Int J Curr Res. 2017;9(07):54135–8.
48.
Kvestad I, Hysing M, Shrestha M, Ulak M, Thorne-Lyman AL, Henjum S, et al. Vitamin B-12 status in infancy is positively associated with development and cognitive functioning 5 y later in Nepalese children. Am J Clin Nutr. 2017;105(5):1122–31.CrossRef
49.
Gu H, Wang L, Liu L, Luo X, Wang J, Hou F, et al. A gradient relationship between low birth weight and IQ: a meta-analysis. Sci Rep. 2017;7:18035.CrossRef
50.
Kormos CE, Wilkinson AJ, Davey CJ, Cunningham AJ. Low birth weight and intelligence in adolescence and early adulthood: a meta-analysis. J Public Health (Oxf). 2014;36(2):213–24.CrossRef
51.
Kerr-Wilson CO, Mackay DF, Smith GC, Pell JP. Meta-analysis of the association between preterm delivery and intelligence. J Public Health (Oxf). 2012;34(2):209–16.CrossRef
52.
de Kieviet JF, Piek JP, Aarnoudse-Moens CS, Oosterlaan J. Motor development in very preterm and very low-birth-weight children from birth to adolescence: a meta-analysis. JAMA. 2009;302(20):2235–42.CrossRef
53.
54.
Lee AC, Kozuki N, Cousens S, Stevens GA, Blencowe H, Silveira MF, et al. Estimates of burden and consequences of infants born small for gestational age in low and middle income countries with INTERGROWTH-21st standard: analysis of CHERG datasets. BMJ. 2017;j4229:358.
55.
Ertem IO, Krishnamurthy V, Mulaudzi MC, Sguassero Y, Balta H, Gulumser O, et al. Similarities and differences in child development from birth to age 3 years by sex and across four countries: a cross-sectional, observational study. Lancet Glob Health. 2018;6(3):e279–91.CrossRef
Metadata
Title
Cognitive and motor outcomes in children born low birth weight: a systematic review and meta-analysis of studies from South Asia
Authors
Ravi Prakash Upadhyay
Gitismita Naik
Tarun Shankar Choudhary
Ranadip Chowdhury
Sunita Taneja
Nita Bhandari
Jose Carlos Martines
Rajiv Bahl
Maharaj Kishan Bhan
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2019
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-019-1408-8

Other articles of this Issue 1/2019

BMC Pediatrics 1/2019 Go to the issue

Research article

Development and validation of a Chinese parental health literacy questionnaire for caregivers of children 0 to 3 years old

Research article

Association between severe unaddressed dental needs and developmental health at school entry in Canada: a cross-sectional study

Study protocol

Study of Environmental Enteropathy and Malnutrition (SEEM) in Pakistan: protocols for biopsy based biomarker discovery and validation

Correction

Correction to: Is vitamin C enough? A case report of scurvy in a five-year-old girl and review of the literature

Study protocol

Evaluation of treatment response, drug resistance and HIV-1 variability among adolescents on first- and second-line antiretroviral therapy: a study protocol for a prospective observational study in the centre region of Cameroon (EDCTP READY-study)

Research article

An economic analysis of human milk supplementation for very low birth weight babies in the USA