{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T10:15:33Z","timestamp":1783678533124,"version":"3.55.0"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Extrauterine growth restriction (EUGR) is common in preterm infants and may impair neurodevelopment. The absence of a standardized definition limits early identification. We evaluated agreement and factors associated with EUGR using cross-sectional and longitudinal definitions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Matched case\u2013control study in three kangaroo mother care programs. EUGR was defined cross-sectionally and longitudinally. Cases were matched by gestational age and city (1:2 cross-sectional; 1:1 longitudinal). Conditional logistic regression assessed associations with maternal, perinatal, and nutritional factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 221 cross-sectional cases with 442 controls and 287 longitudinal cases with 287 controls. Agreement between definitions was fair (\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.32). For both definitions, enrollment in workers\u2019 health insurance and longer hospital stay were associated with higher EUGR odds, whereas any formula feeding was associated with lower odds. Among infants receiving parenteral nutrition, delayed weight recovery and longer hospitalization increased EUGR odds, while higher carbohydrate intake and exclusive formula feeding reduced it. In the longitudinal model, neonatal intensive care unit stay and patent ductus arteriosus increased odds, whereas more hours in kangaroo position reduced it.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Poor agreement between EUGR definitions and differences in associated factors underscore the need to standardize EUGR definitions to optimize and individualize enteral and parenteral nutritional support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>This multicenter study shows that 30\u201340% of Colombian preterm infants &lt;35 weeks GA develop EUGR, with the longitudinal definition capturing earlier growth faltering and the cross-sectional one more severe and persistent failure.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Poor concordance between cross-sectional and longitudinal EUGR definitions and differences in associated factors highlight the need for a standardized EUGR definition and for optimized, individualized enteral and parenteral nutritional support in preterm infants.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>By contrasting EUGR definitions and identifying modifiable factors, this study adds novel evidence from a middle-income setting. Its impact is to guide context-specific nutritional protocols and strengthen early growth monitoring in neonatal care.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41390-026-05256-1","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T09:32:44Z","timestamp":1783675964000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Extrauterine growth restriction definitions and associated factors among Colombian preterm infants: a case control study"],"prefix":"10.1038","author":[{"given":"Adriana","family":"Montealegre-Pomar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Charpak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mart\u00edn Alonso","family":"Rond\u00f3n Sep\u00falveda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magda Cristina","family":"Cepeda Gil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"5256_CR1","doi-asserted-by":"crossref","unstructured":"Ashorn P. et al. Small vulnerable newborns\u2014big potential for impact. Lancet [Internet] [cited 2024 Apr 19]. 401, 1692\u20131706 (2023). Available from: https:\/\/www.thelancet.com\/","DOI":"10.1016\/S0140-6736(23)00354-9"},{"key":"5256_CR2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2022.111912","volume":"107","author":"L Gao","year":"2023","unstructured":"Gao, L. et al. Effect of early initiation of enteral nutrition on short-term clinical outcomes of very premature infants: a national multicenter cohort study in China. Nutrition 107, 111912 (2023).","journal-title":"Nutrition"},{"key":"5256_CR3","doi-asserted-by":"crossref","unstructured":"Gonz\u00e1lez-Garc\u00eda L. et al. Postnatal growth faltering: growth and height improvement at two years in children with very low birth weight between 2002\u20132017. Children 9, (2022). Available from: https:\/\/www.embase.com\/search\/results?subaction=viewrecord&id=L2020731927&from=export","DOI":"10.3390\/children9121800"},{"key":"5256_CR4","unstructured":"Guellec I. et al. Effect of intra- and extrauterine growth on long-term neurologic outcomes of very preterm infants. J. Pediatr. 175, 93-99.e1 (2016). Available from: https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S0022347616302359"},{"key":"5256_CR5","doi-asserted-by":"crossref","unstructured":"Meyers J. M. et al. Neurodevelopmental outcomes in postnatal growth-restricted preterm infants with postnatal head-sparing. J. Perinatol. 36 (2016).","DOI":"10.1038\/jp.2016.154"},{"key":"5256_CR6","first-page":"325","volume":"89","author":"Avila-Alvarez","year":"2018","unstructured":"Avila-Alvarez et al. Extrauterine growth restriction among neonates with a birthweight less than 1500 grams. Pediatrics 89, 325\u2013332 (2018).","journal-title":"Pediatrics"},{"key":"5256_CR7","doi-asserted-by":"publisher","first-page":"986","DOI":"10.1542\/peds.111.5.986","volume":"111","author":"RH Clark","year":"2003","unstructured":"Clark, R. H., Thomas, P. & Peabody, J. Extrauterine growth restriction: is it preventable? Pediatrics 111, 986\u2013990 (2003).","journal-title":"Pediatrics"},{"key":"5256_CR8","first-page":"132","volume":"24","author":"W Shen","year":"2022","unstructured":"Shen, W. et al. Incidence of extrauterine growth retardation and its risk factors in very preterm infants during hospitalization: a multicenter prospective study. Chin. J. Contemp. Pediatr. 24, 132\u2013140 (2022).","journal-title":"Chin. J. Contemp. Pediatr."},{"key":"5256_CR9","doi-asserted-by":"publisher","first-page":"1644","DOI":"10.12669\/pjms.38.6.5864","volume":"38","author":"M Sun","year":"2022","unstructured":"Sun, M. et al. Analysis of extrauterine growth retardation and related risk factors in 132 premature infants. Pak. J. Med. Sci. 38, 1644\u20131648 (2022).","journal-title":"Pak. J. Med. Sci."},{"key":"5256_CR10","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1016\/j.ejpn.2021.06.004","volume":"33","author":"DU De Rose","year":"2021","unstructured":"De Rose, D. U. et al. Extra-uterine growth restriction in preterm infants: neurodevelopmental outcomes according to different definitions. Eur. J. Paediatr. Neurol. 33, 135\u2013145 (2021).","journal-title":"Eur. J. Paediatr. Neurol."},{"key":"5256_CR11","doi-asserted-by":"crossref","unstructured":"Gonz\u00e1lez-L\u00f3pez C. et al. Variability in definitions and criteria of extrauterine growth restriction and its association with neurodevelopmental outcomes in preterm infants: a narrative review. Nutrients. 16, (2024). Available from: https:\/\/www.embase.com\/search\/results?subaction=viewrecord&id=L2029396686&from=export","DOI":"10.3390\/nu16070968"},{"key":"5256_CR12","unstructured":"Maiocco G. et al. Extrauterine growth restriction (EUGR) in infants born before 30 weeks of gestational age: Comparison of diverse definitions in association with neurodevelopmental and auxological outcomes at 24 months of corrected age. Ital. J. Pediatr. 45, (2019). Available from: https:\/\/www.embase.com\/search\/results?subaction=viewrecord&id=L630629100&from=export"},{"key":"5256_CR13","doi-asserted-by":"crossref","unstructured":"Peila C. et al. Extrauterine growth restriction: Definitions and predictability of outcomes in a cohort of very low birth weight infants or preterm neonates. Nutrients 12, (2020). Available from: https:\/\/www.embase.com\/search\/results?subaction=viewrecord&id=L2004246687&from=export","DOI":"10.3390\/nu12051224"},{"key":"5256_CR14","doi-asserted-by":"crossref","unstructured":"Zozaya C., D\u00edaz C., De Pipa\u00f3n M. S. How should we define postnatal growth restriction in preterm infants? Neonatology. 114, (2018).","DOI":"10.1159\/000489388"},{"key":"5256_CR15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/bmjpo-2020-000765","volume":"4","author":"NW Gidi","year":"2020","unstructured":"Gidi, N. W. et al. Incidence and associated factors of extrauterine growth restriction (EUGR) in preterm infants, a cross-sectional study in selected NICUs in Ethiopia. BMJ Paediatr. Open 4, 1\u20136 (2020).","journal-title":"BMJ Paediatr. Open"},{"key":"5256_CR16","doi-asserted-by":"publisher","first-page":"553","DOI":"10.23736\/S2724-5276.18.05253-2","volume":"74","author":"PC Marques","year":"2022","unstructured":"Marques, P. C., Rocha, G., Flor-De-Lima, F. & Guimar\u00e3es, H. Extrauterine growth restriction at discharge in very-low-birth weight infants: a retrospective study in a level III neonatal intensive care unit. Minerva Pediatr. 74, 553\u2013561 (2022).","journal-title":"Minerva Pediatr."},{"key":"5256_CR17","unstructured":"Dancis J., O\u2019Connell R., Holt L. E. A grid for recording the weight of premature infants [Internet]. New York: 1948. Available from: file:\/\/\/D:\/SkyDrive\/Pediatria Gral\/Revista Medicina Infantil\/97-99\/MedicinaInfantil.pdf"},{"key":"5256_CR18","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/j.jped.2018.10.006","volume":"95","author":"RC Silveira","year":"2019","unstructured":"Silveira, R. C. & Procianoy, R. S. Preterm newborn\u2019s postnatal growth patterns: how to evaluate them. J. Pediatr. 95, 42\u201348 (2019).","journal-title":"J. Pediatr."},{"key":"5256_CR19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fped.2021.690788","volume":"9","author":"L Gonz\u00e1lez-Garc\u00eda","year":"2021","unstructured":"Gonz\u00e1lez-Garc\u00eda, L. et al. Extrauterine growth restriction in very low birth weight infants: concordance between Fenton 2013 and INTERGROWTH-21st Growth Charts. Front. Pediatr. 9, 1\u201310 (2021).","journal-title":"Front. Pediatr."},{"key":"5256_CR20","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1186\/1471-2431-13-59","volume":"13","author":"TR Fenton","year":"2013","unstructured":"Fenton, T. R. & Kim, J. H. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatr. 13, 59 (2013).","journal-title":"BMC Pediatr."},{"key":"5256_CR21","unstructured":"Vanderbilt University., REDCap Consortium. REDCap technical overview introduction [Internet]. 2017;1\u20136. Available from: https:\/\/redcap.vanderbilt.edu\/consortium\/REDCapTechnicalOverview.pdf"},{"key":"5256_CR22","unstructured":"Stata Press. STATA power and sample-size reference manual. 2013."},{"key":"5256_CR23","doi-asserted-by":"publisher","first-page":"A617","DOI":"10.1210\/jendso\/bvaa046.1219","volume":"4","author":"M Del Pistoia","year":"2020","unstructured":"Del Pistoia, M. et al. Extrauterine growth restriction (EUGR) in preterm infants: incidence, risk factors, nutrition, auxological and neurological outcome.a retrospective study from 2010 to 2016. J. Endocr. Soc. 4, A617\u2013A618 (2020).","journal-title":"J. Endocr. Soc."},{"key":"5256_CR24","doi-asserted-by":"crossref","unstructured":"World Medical Association. World Medical Association Declaration of Helsinki. 2001.","DOI":"10.4414\/smf.2001.04031"},{"key":"5256_CR25","unstructured":"Ministerio de Salud de Colombia. Resoluci\u00f3n N\u00famero 8430 [Internet]. 1993. Available from: https:\/\/www.minsalud.gov.co\/Normatividad_Nuevo\/RESOLUCION 8430 DE 1993.pdf"},{"key":"5256_CR26","first-page":"119","volume":"52","author":"D-F Rojas-Gualdr\u00f3","year":"2020","unstructured":"Rojas-Gualdr\u00f3, D.-F., Vel\u00e1squez-Ospina, J., Tejada-Tobon, M. & Pineda-S\u00e1nchez, J. Distribuci\u00f3n geogr\u00e1fica del cambio en mortalidad neonatal seg\u00fan bajo peso al nacer, Colombia 2008-2017. Rev. la Univ. Ind. Santander Salud 52, 119\u2013128 (2020).","journal-title":"Rev. la Univ. Ind. Santander Salud"},{"key":"5256_CR27","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1080\/17446651.2022.2110468","volume":"17","author":"L Lucaccioni","year":"2022","unstructured":"Lucaccioni, L., Iughetti, L., Berardi, A. & Predieri, B. Challenges in the growth and development of newborns with extra-uterine growth restriction. Expert Rev. Endocrinol. Metab. 17, 415\u2013423 (2022).","journal-title":"Expert Rev. Endocrinol. Metab."},{"key":"5256_CR28","doi-asserted-by":"publisher","first-page":"1733","DOI":"10.1016\/S0140-6736(23)00355-0","volume":"401","author":"GJ Hofmeyr","year":"2023","unstructured":"Hofmeyr, G. J. et al. Evidence-based antenatal interventions to reduce the incidence of small vulnerable newborns and their associated poor outcomes. Lancet 401, 1733\u20131744 (2023).","journal-title":"Lancet"},{"key":"5256_CR29","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1016\/j.pcl.2018.12.009","volume":"66","author":"K Kesavan","year":"2019","unstructured":"Kesavan, K. & Devaskar, S. U. Intrauterine growth restriction: postnatal monitoring and outcomes. Pediatr. Clin. North Am. 66, 403\u2013423 (2019).","journal-title":"Pediatr. Clin. North Am."},{"key":"5256_CR30","doi-asserted-by":"publisher","unstructured":"Lin Y.-H. et al. The association of macronutrients in human milk with the growth of preterm infants. PLoS One. 1\u201312 https:\/\/doi.org\/10.1371\/journal.pone.0230800 (2020).","DOI":"10.1371\/journal.pone.0230800"},{"key":"5256_CR31","first-page":"38","volume":"66","author":"A Nandakumar","year":"2020","unstructured":"Nandakumar, A., Pournami, F., Prabhakar, J. & Jain, N. Exclusive breast milk vs. hybrid milk feeding for preterm babies-a randomized controlled trial comparing time to full feeds. J. Trop. Pediatr. 66, 38\u201345 (2020).","journal-title":"J. Trop. Pediatr."},{"key":"5256_CR32","volume":"8","author":"O SJ","year":"2021","unstructured":"SJ, O., Young, L. & McGuire, W. Slow advancement of enteral feed volumes to prevent necrotising enterocolitis in very low birth weight infants. Cochrane database Syst. Rev. 8, CD001241 (2021).","journal-title":"Cochrane database Syst. Rev."},{"key":"5256_CR33","doi-asserted-by":"crossref","unstructured":"Abiramalatha T., Thomas N., Thanigainathan S. High versus standard volume enteral feeds to promote growth in preterm or low birth weight infants. Cochrane Database Syst. Rev. 2021, (2021).","DOI":"10.1002\/14651858.CD012413.pub3"},{"key":"5256_CR34","first-page":"347","volume":"38","author":"S Arslanoglu","year":"2010","unstructured":"Arslanoglu, S., Ziegler, E. E. & Moro, G. E. Nutr WWG. Donor human milk in preterm infant feeding: evidence and recommendations. J. Perinat. Med. 38, 347\u2013351 (2010).","journal-title":"J. Perinat. Med."},{"key":"5256_CR35","doi-asserted-by":"crossref","unstructured":"Li Y. et al. Efficacy of donated milk in early nutrition of preterm infants: a meta-analysis. Nutrients 14 (2022).","DOI":"10.3390\/nu14091724"},{"key":"5256_CR36","doi-asserted-by":"publisher","first-page":"e88392","DOI":"10.1371\/journal.pone.0088392","volume":"9","author":"N Morisaki","year":"2014","unstructured":"Morisaki, N. et al. Brief parenteral nutrition accelerates weight gain, head growth even in healthy VLBWs. PLoS One 9, e88392 (2014).","journal-title":"PLoS One"},{"key":"5256_CR37","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.jpeds.2020.08.024","volume":"228","author":"W Alburaki","year":"2021","unstructured":"Alburaki, W. et al. High early parenteral lipid in very preterm infants: a randomized-controlled trial. J. Pediatr. 228, 16\u201323.e1 (2021).","journal-title":"J. Pediatr."},{"key":"5256_CR38","doi-asserted-by":"crossref","unstructured":"Shrikant K. N. et al. Reducing extrauterine growth restriction in very preterm neonates: a before-after intervention study. Nutr. Clin. Pract. 1239\u20131246 (2024).","DOI":"10.1002\/ncp.11165"},{"key":"5256_CR39","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1002\/ncp.10210","volume":"34","author":"F Hu","year":"2019","unstructured":"Hu, F. et al. Analysis of nutrition support in very low-birth-weight infants with extrauterine growth restriction. Nutr. Clin. Pr. 34, 436\u2013443 (2019).","journal-title":"Nutr. Clin. Pr."},{"key":"5256_CR40","unstructured":"Wang L. et al. Risk factors of extrauterine growth restriction in very preterm infants with bronchopulmonary dysplasia: a multi-center study in China. BMC Pediatr. (2022). Available from: https:\/\/bmcpediatr.biomedcentral.com\/articles\/10.1186\/s12887-022-03405-z"},{"key":"5256_CR41","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1111\/apa.15489","volume":"110","author":"N Charpak","year":"2021","unstructured":"Charpak, N., Montealegre-Pomar, A. & Bohorquez, A. Systematic review and meta-analysis suggest that the duration of Kangaroo mother care has a direct impact on neonatal growth. Acta Paediatr. 110, 45\u201359 (2021).","journal-title":"Acta Paediatr."},{"key":"5256_CR42","doi-asserted-by":"publisher","first-page":"1751","DOI":"10.1016\/S0140-6736(23)01000-0","volume":"401","author":"GL Darmstadt","year":"2023","unstructured":"Darmstadt, G. L. et al. WHO Global Position Paper and Implementation Strategy on kangaroo mother care call for fundamental reorganisation of maternal\u2013infant care. Lancet 401, 1751\u20131753 (2023).","journal-title":"Lancet"},{"key":"5256_CR43","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1007\/s00431-008-0885-9","volume":"168","author":"HM Shan","year":"2009","unstructured":"Shan, H. M. et al. Extrauterine growth retardation in premature infants in Shanghai: a multicenter retrospective review. Eur. J. Pediatr. 168, 1055\u20131059 (2009).","journal-title":"Eur. J. Pediatr."},{"key":"5256_CR44","first-page":"1","volume":"104","author":"ET Andrews","year":"2018","unstructured":"Andrews, E. T. et al. Early postnatal growth failure in preterm infants is not inevitable. Arch. Dis. Child 104, 1\u20137 (2018).","journal-title":"Arch. Dis. Child"},{"key":"5256_CR45","doi-asserted-by":"publisher","first-page":"2634","DOI":"10.1080\/14767058.2019.1670795","volume":"34","author":"KV Reddy","year":"2021","unstructured":"Reddy, K. V. et al. Comparison of Fenton 2013 growth curves and Intergrowth-21 growth standards to assess the incidence of intrauterine growth restriction and extrauterine growth restriction in preterm neonates \u226432 weeks. J. Matern Neonatal Med. 34, 2634\u20132641 (2021).","journal-title":"J. Matern Neonatal Med."},{"key":"5256_CR46","doi-asserted-by":"publisher","first-page":"4073","DOI":"10.1007\/s00431-024-05673-6","volume":"183","author":"C Gonz\u00e1lez L\u00f3pez","year":"2024","unstructured":"Gonz\u00e1lez L\u00f3pez, C. et al. Extrauterine growth restriction in very-low-birthweight infants: prevalence and concordance according to Fenton, Olsen, and INTERGROWTH-21st growth charts in a multicenter Spanish cohort. Eur. J. Pediatr. 183, 4073\u20134083 (2024).","journal-title":"Eur. J. Pediatr."}],"container-title":["Pediatric Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41390-026-05256-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41390-026-05256-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41390-026-05256-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T09:32:48Z","timestamp":1783675968000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41390-026-05256-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,10]]},"references-count":46,"alternative-id":["5256"],"URL":"https:\/\/doi.org\/10.1038\/s41390-026-05256-1","relation":{},"ISSN":["0031-3998","1530-0447"],"issn-type":[{"value":"0031-3998","type":"print"},{"value":"1530-0447","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,10]]},"assertion":[{"value":"26 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 April 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 May 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 July 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Informed consent to participate in the study was obtained from parents when enrolled into the Kangaroo Mother Care Programs.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}