Impact of Integrated Interventions in the Next 1000 days to Promote Optimum Growth, Neurodevelopment and Metabolic Health in Small and Vulnerable Children (SAMPOORNA)

Small and vulnerable newborns (SVNs) represent a significant public health concern, particularly in South Asia, which accounts for 63% of global term SGA births and has a preterm birth prevalence of 13.2%. These infants are at increased risk for stunted growth, cognitive delays, and metabolic disorders. Although interventions during the first 24 months of life have demonstrated some benefits, there is a notable lack of sustained improvements in growth, neurodevelopment, and metabolic health as SVNs transition into early childhood. This gap underscores the urgent need for research and innovation targeting the next 1,000 days (ages 2 to 5 years), a critical but underexplored period for long-term child health.

Hence a randomized controlled factorial trial is designed to evaluate the impact of an integrated package of interventions including optimized nutrition, developmental stimulation, and maternal support delivered from age 2 to 5 years to children born preterm or term SGA. Eligible children from an established cohort will be re-randomized at 24 months and followed through 5 years of age, with outcomes assessed for growth (height-for-age z-score), cognitive development, and metabolic health. The trial aims to generate high-quality evidence on scalable, multi-domain interventions to improve growth, neurodevelopment, and metabolic outcomes in SVNs. Results will inform future child health policies and programs and address a critical knowledge gap in the care of this high-risk group.