Growth Failure in Preterm Infants with Cerebral Palsy

Abstract

Developmental and Behavioral Pediatrics| April 01 1999 Growth Failure in Preterm Infants with Cerebral Palsy AAP Grand Rounds (1999) 1 (4): 34. https://doi.org/10.1542/gr.1-4-34 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Growth Failure in Preterm Infants with Cerebral Palsy. AAP Grand Rounds April 1999; 1 (4): 34. https://doi.org/10.1542/gr.1-4-34 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: cerebral palsy, infant, premature Source: Rogers B, Andrus J, Msall ME, et al. Growth of preterm infants with cystic periventricular leukomalacia. Dev Med & Child Neuro. 1998;40:580–586. The cause of growth failure in children with cerebral palsy is poorly understood. Rogers and colleagues studied the growth patterns of an unselected cohort of 51 preterm infants with cystic periventricular leukomalacia (CPVL) with a gestational age of <33 weeks admitted to Children’s Hospital of Buffalo from 1988 to 1993. Of 41 survivors, 39 developed CP. Twenty-four infants had oral feeding impairments which included requiring over 30 minutes to complete a feeding, coughing and gagging while feeding, abnormal chewing, or failure to drink from a cup by 2 years of age. Eighteen subjects developed growth failure during infancy. Of these, the majority (13 of 18) had signs of protein-calorie undernutrition using the Waterlow1 criteria and a growth pattern suggestive of chronic malnutrition in which body mass is gradually lost until linear growth is compromised. The presence of an oral feeding impairment was found to be the sole risk factor for the occurrence of growth failure (p<0.005). Birth weight, gestational age, sex, multiple birth and selected neonatal complications were not significantly associated with growth failure. The authors call for close, early monitoring of feeding abilities and growth in preterm infants, particularly when risk factors for CP such as CPVL are present. This study supplies compelling evidence that undernutrition is associated with growth failure in preterm infants with CPVL and CP, and underscores the need for systematic monitoring of growth and feeding. Despite the relatively small study cohort, a retrospective design, and the lack of raw data on nutritional intake or body composition, this study is noteworthy for its methodological strengths including a well-defined population, inclusion of head circumference data, longitudinal evaluations in the earliest months of life, and the use of well-established norms for undernutrition. The authors note that nutritional disorders are not as frequently recognized and treated in children with CP as they are in children with Crohn’s disease or cystic fibrosis.2 In children with CP, nutritional deficiencies can often be corrected and result in improved growth and cognitive, behavioral and social outcomes.3,4 The authors studied former preemies with CP due to cystic periventricular leukomalacia. While their conclusion cannot be extrapolated to all children with CP, their results do argue for a careful assessment of feeding and protein-calorie intake in any child with CP before growth failure is evident. A larger, equally rigorous study of children with CP from other causes is needed. You do not currently have access to this content.