Abstract
BackgroundPremature infants are at high risk for developmental delay and cognitive dysfunction. Besides medical conditions, growth restriction is regarded as an important risk factor for cognitive and neurodevelopmental dysfunction throughout childhood and adolescence and even into adulthood. In this study, we analyzed the relationship between post-discharge body weight and psychomotor development using a nationwide dataset.Materials and methodsThis was a nationwide cohort study conducted in Taiwan. Total of 1791 premature infants born between 2007 and 2011 with a birth weight of less than 1500 g were enrolled into this multi-center study. The data were obtained from the Taiwan Premature Infant Developmental Collaborative Study Group. The growth and neurodevelopmental evaluations were performed at corrected ages of 6, 12 and 24 months. Post-discharge failure to thrive was defined as a body weight below the 3rd percentile of the standard growth curve for Taiwanese children by the corrected age.ResultsThe prevalence of failure to thrive was 15.8%, 16.9%, and 12.0% at corrected ages of 6, 12, and 24 months, respectively. At corrected ages of 24 months, 12.9% had low Mental Developmental Index (MDI) scores (MDI<70), 17.8% had low Psychomotor Developmental Index (PDI) scores (PDI<70), 12.7% had cerebral palsy, and 29.5% had neurodevelopmental impairment. Post-discharge failure to thrive was significantly associated with poor neurodevelopmental outcomes. After controlling for potential confounding factors (small for gestational age, extra-uterine growth retardation at discharge, cerebral palsy, gender, mild intraventricular hemorrhage, persistent pulmonary hypertension of newborn, respiratory distress syndrome, chronic lung disease, hemodynamic significant patent ductus arteriosus, necrotizing enterocolitis, surfactant use and indomethacin use), post-discharge failure to thrive remained a risk factor.ConclusionThis observational study observed the association between lower body weight at corrected age of 6, 12, and 24 months and poor neurodevelopmental outcomes among VLBW premature infants. There are many adverse factors which can influence the neurodevelopment in NICU care. More studies are needed to elucidate the causal relationship.
Highlights
Post-discharge failure to thrive was significantly associated with poor neurodevelopmental outcomes
Post-discharge body weight and neurodevelopmental outcomes distress syndrome, chronic lung disease, hemodynamic significant patent ductus arteriosus, necrotizing enterocolitis, surfactant use and indomethacin use), post-discharge failure to thrive remained a risk factor. This observational study observed the association between lower body weight at corrected age of 6, 12, and 24 months and poor neurodevelopmental outcomes among very low birth weight (VLBW) premature infants
extra-uterine growth retardation (EUGR) might not be a confounding factor for the correlation between FTT and neurodevelopmental outcomes in this study. This nationwide cohort study revealed that post-discharge failure to thrive in very low birth weight (VLBW) infants was highly associated with poor neurodevelopmental outcomes at three different time points
Summary
Premature infants are at high risk for developmental delay and cognitive dysfunction. [1,2,3,4,5,6] Numerous medical conditions and other variables have been shown to be associated with neurodevelopmental outcomes among premature infants, including gender, small for gestational age (SGA), intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), patent ductus arteriosus (PDA), necrotizing enterocolitis (NEC), and chronic lung disease (CLD). [4, 7,8,9,10,11,12,13,14,15] growth restriction is known to be an important risk factor for cognitive and neurodevelopmental dysfunction throughout childhood and adolescence, and even into adulthood. [1, 2, 4,5,6, 8, 16,17,18,19,20,21,22,23,24] early and aggressive nutritional support is a generally accepted approach for facilitating better growth in very low birth weight (VLBW) preterm infants, [25,26,27] post-natal growth restriction is still common among those infants. [28,29,30] the growth of a VLBW infant after discharge from hospitals is considered to be an important and controllable factor for the infant’s long-term psychomotor development. [31,32,33,34,35,36,37] In this study, we analyzed the relationship between post-discharge body weight and psychomotor development using a nationwide dataset. [4, 7,8,9,10,11,12,13,14,15] growth restriction is known to be an important risk factor for cognitive and neurodevelopmental dysfunction throughout childhood and adolescence, and even into adulthood. [28,29,30] the growth of a VLBW infant after discharge from hospitals is considered to be an important and controllable factor for the infant’s long-term psychomotor development. Growth restriction is regarded as an important risk factor for cognitive and neurodevelopmental dysfunction throughout childhood and adolescence and even into adulthood. We analyzed the relationship between post-discharge body weight and psychomotor development using a nationwide dataset
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