Effect of Maternal Hemoglobin on Neurobehavioural Development of Late Preterm Neonates : A Cohort Study
Condition: Anemia
MeSH terms: Premature Birth
Study type: Observational

Summary: 
      The study entitled 'Effect of maternal hemoglobin on neurobehavioral development of late
      preterm neonates' was done with an objective to determine whether low maternal hemoglobin
      (<11gm/dl), in late preterm neonates(>34weeks but less than 37weeks gestational age)
      correlates with poor neurobehavioral outcome using the Neurobehavioral Assessment of Preterm
      Infants(NAPI) tool, thereby allowing for earlier rehabilitative intervention to be undertaken
      to improve their long term outcomes and to generate useful data on a previously well
      recognised but under researched entity.
    

Detailed description: 
      Prevalence of anemia in India is among the highest in the world. A high proportion of women
      in both industrialized and developing countries become anemic during pregnancy. The major
      concern about the adverse effects of anemia on pregnant women and their offsprings is the
      belief that this population is at a greater risk of perinatal mortality and morbidity. Apart
      from this, it is well known that anemia per se is associated with higher incidence of
      premature births and low birth weight babies. Infants with iron deficiency anemia have
      significantly lower motor and mental scores and decreased language capabilities and body
      balance-coordination skills. Such infants also have a decreased learning ability. Iron
      deficiency anemia during the developmental stage can lead to reduced myelination of the
      spinal cord, as well as a change in myelin composition; abnormalities in neurotransmitters'
      metabolism and alteration in brain energy metabolism. The Neurobehavioral Assessments of
      Preterm Infants (NAPI) is a research tool to monitor the developmental progress and
      differential maturity of preterm infants ranging between 32weeks and 37weeks (full term).
      This test is used to identify persistent lags in development, as a research tool to assess
      effects of interventions and to study individual differences and basic developmental
      questions. The reliability and clinical validity of this test has been thoroughly
      investigated and normative data has been established.

      Objective - To evaluate the neurobehavioral development at 37weeks of post conceptional age
      in late preterm infants born to mothers with hemoglobin <11gm/dl; by a standardised scale -
      Neurobehavioral Assessment of Preterm Infants (NAPI).
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        100 late preterms (56 cases vs. 44 controls) fulfilling the criteria were enrolled from
        Main Labor Room, Maternity Ward, Operation Theatre or Post Natal Wards of the Department of
        Obstetrics and Gynaecology, Lady Hardinge Medical College.

        NAPI was administerd to 63 neonates (32 cases vs 31 controls).
      
Keywords: Late Preterms; Neurobehavioral Assessment of Preterm Infants (NAPI)