Introduction: Globally, India accounts for the highest burden of preterm births, with approximately 3.5 million infants born prematurely each year. Within the state of Tamil Nadu, rural and developing districts like Tirupattur encounter persistent challenges in infant health due to regional socioeconomic barriers, limited access to tertiary neonatal setups, and a lack of structured transition care when infants leave special newborn care units (SNCUs). The post-discharge home environment is heavily influenced by parental self-efficacy and care practices. In rural districts, traditional, unscientific newborn care practices often inadvertently worsen outcomes for vulnerable preterm infants. Modifiable post-discharge risk factors include improper positioning during feeding, poor temperature regulation, premature introduction of complementary foods, and a distinct lack of early neurosensory stimulation. Objective: The primary objective of this study was to evaluate whether infant growth and neurodevelopmental outcomes differed between treatment arms testing a structured, nurse-led preterm care package provided to parents at discharge. Methods: Mothers of preterm infants (born <37 weeks gestation) stable for discharge were recruited from a secondary care newborn unit in Tirupattur District, Tamil Nadu, between May 2024 and April 2025. Post-discharge data were collected from 30 experimental participants (receiving the nurse-led care package) and 30 control participants (receiving standard discharge counseling) up to 6 months of corrected age. Infant growth (weight, length, and head circumference) was monitored monthly, and neurodevelopmental status was evaluated at 6 months using the Trivandrum Developmental Screening Chart (TDSC). Time-to-event curves and logistic regression models were applied to compare outcomes. Results: Retention rates for the experimental and control arms at 6 months were 90% (27/30) and 86.7% (26/30), respectively. Preterm infants in the experimental group demonstrated a significantly shorter median time to achieve adequate catch-up growth (defined as weight-for-age > 10th percentile) compared to the control group (3.5 months vs. 5.5 months; p = 0.032). At 6 months of corrected age, the prevalence of developmental delay (failing > 1 item on the TDSC) was significantly lower in the experimental arm than in the control arm (11.1% vs. 34.6%; p = 0.041). Conclusions: A structured, nurse-led preterm care package focused on responsive feeding, thermal management, infection control, and sensory stimulation significantly improves early physical growth and minimizes developmental delays in preterm infants compared to standard educational curriculums.
Preterm care, nurse-led intervention, catch-up growth, developmental delay, Tamil Nadu, low-resource settings.
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