Head growth during neonatal intensive care unit stay is related to the neurodevelopmental outcomes of preterm small for gestational age infants

Hannah Cho,Ee-Kyung Kim,In Gyu Song,Ju Sun Heo,Seung Han Shin,Han-Suk Kim

doi:10.1016/j.pedneo.2021.05.023

Hannah Cho, Ee-Kyung Kim + Show 4 more

Open Access

https://doi.org/10.1016/j.pedneo.2021.05.023

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Abstract

To investigate postnatal growth patterns and their relationship with the neurodevelopment of preterm infants born small for gestational age (SGA). This retrospective cohort study analyzed 90 infants born SGA with a birthweight <1500g or gestational age <32 weeks. Length, weight, and head circumference (HC) were recorded at birth, 35 weeks postmenstrual age (PMA), 40 weeks PMA, and 4, 9, and 18 months corrected age (CA). Neurodevelopmental outcomes were assessed using the Bayley-III scales at 18 months CA. The Z-score of HC in SGA infants increased from birth to 40 weeks PMA. Failure of head growth catch-up to the 10th percentile by four months CA and all three parameters by nine months CA were associated with worse neurodevelopmental outcomes. Z-score changes in head growth between birth and 35 weeks PMA were significantly associated with neurodevelopmental outcomes (p=0.006; adjusted odds ratio, 6.964; 95% confidence interval: 1.763-27.506). Head growth trajectory during neonatal intensive care unit stay is associated with neurodevelopmental outcomes in preterm SGA infants. If head growth catch-up is achieved by four months CA and length and weight catch-up by nine months CA, preterm SGA infants are predicted to have optimal neurodevelopment at 18 months CA.

Highlights

Postnatal growth in length, weight, and head circumference is associated with later neurodevelopmental outcomes in preterm infants.1e8 preterm infants born small for gestational age (SGA) were sometimes excluded from studies which explored the relationship between postnatal growth and development or they comprised a small proportion of the study population
Key Words catch-up growth; neurodevelopment; preterm infant; small for gestational age Background: To investigate postnatal growth patterns and their relationship with the neurodevelopment of preterm infants born small for gestational age (SGA)
Weight, and head circumference is associated with later neurodevelopmental outcomes in preterm infants.1e8 preterm infants born small for gestational age (SGA) were sometimes excluded from studies which explored the relationship between postnatal growth and development or they comprised a small proportion of the study population

Summary

Introduction

Weight, and head circumference is associated with later neurodevelopmental outcomes in preterm infants.1e8 preterm infants born small for gestational age (SGA) were sometimes excluded from studies which explored the relationship between postnatal growth and development or they comprised a small proportion of the study population. Studies focusing on the growth patterns and neurodevelopmental outcomes of preterm SGA infants are limited1,2,14e16 and all but one study analyzed the preterm population born before the 90s. For this reason, while catch-up growth is one of the main goals of following-up preterm SGA infants, controversy exists over the time frame within which it should occur for this population. To investigate postnatal growth patterns and their relationship with the neurodevelopment of preterm infants born small for gestational age (SGA). If head growth catch-up is achieved by four months CA and length and weight catch-up by nine months CA, preterm SGA infants are predicted to have optimal neurodevelopment at 18 months CA

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