# Neurodevelopmental delay and associated factors among preterm infants aged 6 to 24 months adjusted gestation age in two urban hospitals in Uganda

## TL;DR

The study found that 13.6% of preterm infants in Uganda aged 6-24 months show neurodevelopmental delays, with social and fine motor delays being most common.

## Contribution

This study provides new data on neurodevelopmental outcomes in preterm infants in Uganda, identifying key modifiable risk factors.

## Key findings

- Neurodevelopmental delay (NDD) was found in 13.6% of preterm infants.
- Social delay was the most prevalent type of NDD, followed by fine motor delay.
- Factors like malnutrition, lack of social support, and incomplete immunization were strongly associated with NDD.

## Abstract

Neurodevelopmental delay has been reported among preterm infants who survive beyond the neonatal period. However, there is paucity of data regarding neurodevelopmental outcomes in preterm infants in Africa, including Uganda. This study aimed to determine the prevalence and factors associated with neurodevelopment delay (NDD) in preterm infants aged 6–24 months of adjusted gestation age. A cross-sectional study was conducted among 206 preterm infants, aged between 6 and 24 months of adjusted gestation age in the preterm follow up clinics at St. Francis Hospital Nsambya and Mulago Specialized Women and Neonatal Hospital in Kampala-Uganda from 25th January 2021–25th January 2022. The prevalence of NDD was 13.6% (28/206), with social delay comprising 12.1% (25/206), fine motor delay 11.7% (24/206), language delay 10.7% (22/206) and gross motor delay 7.8% (16/206). Significant factors associated with NDD included microcephaly [aPR = 6.2, CI: 2.6-33.5, P < 0.001], severe acute malnutrition (SAM) [aPR = 4.6, CI: 1.87-12.56, P = 0.021], incomplete immunization [aPR = 2.8, CI: 1.23-4.76, P = 0.013], neonatal sepsis [aPR = 3.8, CI: 1.1-9.3, P = 0.026], neonatal hypoglycemia [aPR = 6.2, CI: 1.8-16.4, P = 0.002], lack of caretaker social support [aPR = 8.3, CI: 2.43-37.9, P = 0.002] and large family size (≥5 children) [aPR = 6.8, CI: 2.24-22.7, P = 0.002]. NDD affects 13.6% of preterm infants, with the social and fine motor delays being most prevalent. Modifiable factors like malnutrition, lack of caretaker social support and incomplete immunization should be screened and addressed to reduce NDD among preterm infants in Uganda.