Prevalence and Factors Associated with Neurodevelopmental Delay Among Preterm Infants Aged 6 Months at Jinja and Kayunga Regional Referral Hospital in Uganda

Abstract Background Neurodevelopmental delays are a major concern for preterm infants in Uganda, but there is limited research detailing how common these delays are by six months of age. This study investigated the prevalence and factors linked to neurodevelopmental delay in six-month-old preterm infants at two regional hospitals, Kayunga and Jinja, addressing a key gap in existing data. Methods A hospital-based cross-sectional study was conducted among 275 preterm infants aged six months corrected age, attending follow-up care at Kayunga and Jinja Regional Referral Hospitals (KRRH and JRRH). The study assessed the prevalence, associated factors, and common clinical features of neurodevelopmental delay (NDD). Neurodevelopment was evaluated using the Malawi Developmental Assessment Tool (MDAT). Infants failing two or more age-appropriate items in a single domain were classified as having developmental delay, while those with delays in two or more domains were categorized as having global developmental delay. Binary logistic regression was used to identify factors independently associated with NDD. Results Among the 275 infants, NDD was found in 35, representing a prevalence of 12.7%. The independent associated factors of neurodevelopmental delay were duration of labour lasting more than 24 hours (aOR = 2.210, CI = 1.890–5.491, P = 0.047), gestational age < 28 weeks (aOR = 2.543, CI = 1.667–6.569, P = 0.011), presence of microcephaly (aOR = 4.099, CI = 0.829–31.378, P = 0.041) and presence of malnutrition; (aOR = 3.555, CI = 1.696–18.189, P = 0.005) for moderate acute malnutrition and (aOR = 5.272, CI = 9.980-74.524, p < 0.001) for severe acute malnutrition. The most commonly impaired domain was social skills (30/35), followed by fine motor skills (25/35), language skills (19/35) and gross motor (14/35). Conclusion The rate of development of neurodevelopment delay was high, as it was seen in one infant for every 10 preterm infants. Routine developmental screening programs like neurobehavioral assessments should be developed in Ugandan hospitals for early identification and management of developmental delays for a better outcome. The nutrition of preterm neonates should be followed up closely, since malnutrition has been associated with NDD.