Impact of Neonatal Intensive Care Unit oral feeding on neuropsychomotor outcomes at 9 months of corrected age in Chinese low-birthweight preterm infants: A retrospective study

Aims and Objectives To examine the changes in neuropsychomotor development and investigate the effect of feeding progression in Neonatal Intensive Care Unit (NICU) on neuropsychomotor outcomes in low-birthweight preterm infants within 9 months of corrected age. Background Low-birthweight (LBW) preterm infants (<37 weeks of gestation and birthweight <2,500 g) are at a high risk for neuropsychomotor development delay. Therefore, exploring NICU practices related to neuropsychomotor development is important. Design This is a retrospective hospital-based cohort study. Methods This study included 196 LBW preterm infants who were admitted to the NICU between January 2014-March 2016 and attended the follow-up growth evaluation in the clinic after discharge. The neuropsychomotor development of preterm infants was assessed every 3 months to a corrected age of 9 months using the paediatric neuropsychomotor diagnostic scale (PNDS). Generalised linear mixed models (GLMM) were performed. Results The total PNDS scores had a downward trend, but the difference on pairwise comparison was not statistically significant. In total, 18.1%, 15.2% and 9.7% of preterm infants were examined for neuropsychomotor disorders at 3, 6 and 9 months of corrected age, respectively. The result of GLMM showed that the early initiation of oral feeding with breast milk was associated with optimal neuropsychomotor development. The first 3 months of corrected age is the critical period for neurodevelopmental disorders. Conclusions This study showed the importance of the early initiation of oral feeding with breast milk as early as possible within the NICU setting and highlighted the importance of close developmental follow-up. Relevance to Clinical Practice The early initiation of oral feeding with breast milk may be recommended to promote neuropsychomotor development of LBW preterm infants within the NICU setting. Early identification of neuropsychomotor developmental delays within the first 3 months may guide early interventions.