Indian Journal Of Pediatrics[JOURNAL]

OBJECTIVES: To estimate the incidence of extrauterine growth restriction (EUGR) in neonates born before 34 wk of gestation and identify associated risk factors. METHODS: A prospective cohort study was conducted in a Leve... OBJECTIVES: To estimate the incidence of extrauterine growth restriction (EUGR) in neonates born before 34 wk of gestation and identify associated risk factors. METHODS: A prospective cohort study was conducted in a Level III neonatal intensive care unit (NICU) from December 2019 to October 2021, including preterm neonates (<34 wk gestation) admitted and survived at least three weeks and crossed birth weight. Neonates with congenital malformations or those transferred before three weeks were excluded. Anthropometric measurements were taken at birth and discharge, and clinical, nutritional, and comorbidity data were analysed. Univariate and multivariate logistic regression identified risk factors for EUGR. RESULTS: Among 152 eligible preterm neonates, the incidence of EUGR was 54.6% (n = 83), with higher rates in extreme preterm (68.9%; n = 20) and very low birth weight (VLBW) infants (75%; n = 63). Lower gestational age, lower birth weight, prolonged total parenteral nutrition (TPN) use, delayed full feeds, and later Kangaroo mother care (KMC) initiation were significantly associated with EUGR. Multivariate analysis identified gestational age {(aOR-14.5 (4.7-45)} and delayed KMC initiation {(aOR-1.3 (1.1-1.5)} as independent predictors of EUGR. CONCLUSIONS: EUGR remains a major concern in preterm neonates, particularly in extremely low birth weight infants. Delayed initiation of KMC was identified as a modifiable risk factor. Early initiation of KMC in NICU settings could be prioritized to reduce EUGR incidence.

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High Risk Follow-Up of NICU Graduates - A Quality Improvement Study at a Tertiary Care Centre.

Patil HN, Joshi AK, Deshmukh LS … +2 more , Londhe AC, Jeena S

Indian J Pediatr · 2026 Jun · PMID 42084819 · Publisher ↗

OBJECTIVES: To increase the facility-based follow-up rate of high-risk neonates at the first visit and subsequent visits until 24 mo of age. METHODS: This quality improvement study was conducted in a tertiary neonatal in... OBJECTIVES: To increase the facility-based follow-up rate of high-risk neonates at the first visit and subsequent visits until 24 mo of age. METHODS: This quality improvement study was conducted in a tertiary neonatal intensive care unit between July 2023 and May 2025. Baseline data were collected, and multiple plan-do-study-act cycles were implemented, including structured pre-discharge counseling, voice call reminders, standard operating procedures, and integration with the District Early Intervention Center. Statistical process control charts were used to monitor the monthly follow-up rates at scheduled visits through 12 mo of age. RESULTS: A total of 1083 high-risk infants were discharged during the study (mean 46 per mo). Follow-up attendance improved significantly at the first visit (from 38% to 100%), at 1 mo (from 36% to 79%), 4 mo (from 32% to 62%), 8 mo (from 26% to 48%), and 12 mo (from 24% to 45%). The pre-discharge counseling rate increased from 40% to > 85%. Voice calls successfully reached 79% of families, and video consultations enabled the assessment of 30-40% of missed visits. Staff transitions lead to special cause variations, underscoring the need for systematic training. CONCLUSIONS: Multipronged low-cost interventions can achieve substantial and sustained improvements in the follow-up rate of high-risk infants in a resource-limited public hospital setting.

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Indian Journal Of Pediatrics[JOURNAL]

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