[8315.2] The Impact of Emollient Therapy During the Neonatal Period on Neurodevelopmental Outcomes
Summer Rosenstock, Naila Z. Khan, Humaira Muslima, Nasreem Begum, Shamim Ferdous, Yoonjoung Choi, Gary L. Darmstadt. International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Child Development and Neurology Unit, Dhaka Shishu (Childrens) Hospital, Dhaka, Bangladesh; Shamim Ferdous, Dhaka Shishu (Childrens) Hospital, Dhaka, Belarus.
BACKGROUND: Preterm babies are at high risk of developmental delays.
OBJECTIVE: To explore whether treatment of preterm newborns with emollient during their stay in a tertiary hospital in Bangladesh had an impact on neurodevelopmental outcomes.
DESIGN/METHODS: Preterm infants (N=118) (< 33 weeks gestational age) were enrolled in a trial of topical emollient therapy, randomized to receive Aquaphor, sunflower oil or no emollient treatment (usual care) and participated in a follow-up study to assess neurodevelopmental outcomes. Infants were assessed at 4 weeks, every three months for the first year and every six months thereafter, with an average of 3.7 follow-ups. Children were assessed separately by a child health physician and a psychologist, using the WHO International Classification of Functioning and the Bayley Scales of Infant Development II.
RESULTS: For several neurodevelopmental outcomes, the control group had higher proportions of developmental delays than the treatment groups. Lowess graphs for a composite outcome of any disability, fine motor skills, cognitive, and speech delays against age suggest that the control group had higher proportions of developmental delays. Confirmatory analysis was run using GEE. Aquaphor and sunflower oil showed some protective effect on development of fine motor skill delays with odds ratios of 0.94 and 0.92 and p-values of 0.076 and 0.047, respectively, compared to the control group.
CONCLUSIONS: Emollient treatment during the neonatal period may lower risk for neurodevelopmental delays in this population, although the sample size was insufficient to confirm this for some outcomes. Further research is warranted on this low-cost, low-tech intervention to address neurodevelopmental outcomes in preterm babies.