Differential Effect of Growth on Development between AGA and SGA Preterm Infants

Predicting developmental outcomes with growth measurement would be beneficial for primary healthcare or in developing countries with low medical resources. This study aimed to identify physical growth measures that indicate neurodevelopment in very preterm infants. Preterm infants, born at <32 weeks’ gestation or weighing <1500 g, were included. We calculated the changes in z-score of weight, length, and head circumference (HC) at different time points: birth, postmenstrual age (PMA) 35 weeks, and 4 and 18 months corrected age (CA). We examined the relationship between growth and Bayley-III scores using linear regression. Among 122 infants, HC at 4 months CA and HC growth between PMA 35 weeks and 4 months CA showed a positive correlation with Bayley-III scores in appropriate-for-gestational-age infants (AGAs). Weight and length increases between birth and 18 months CA were also associated with AGAs’ development. In small-for-gestational-age infants (SGAs), only birthweight’s z-score was associated with improved neurodevelopmental outcomes. HC at 4 months CA was an important indicator of favorable neurodevelopmental outcomes, and head growth spurt between PMA 35 weeks and 4 months CA contributed to this benefit in preterm AGAs. The period and indices should be monitored differently for SGAs and AGAs.

[1]  F. Lorenzoni,et al.  ExtraUterine Growth Restriction (EUGR) in Preterm Infants: Growth Patterns, Nutrition, and Epigenetic Markers. A Pilot Study , 2018, Front. Pediatr..

[2]  A. Synnes,et al.  Head Growth Trajectory and Neurodevelopmental Outcomes in Preterm Neonates , 2017, Pediatrics.

[3]  Sung-Hoon Chung,et al.  Improvement in the Survival Rates of Very Low Birth Weight Infants after the Establishment of the Korean Neonatal Network: Comparison between the 2000s and 2010s , 2017, Journal of Korean medical science.

[4]  J. Espinoza,et al.  Clinical Management Guidelines for Obstetrician – Gynecologists , 2019 .

[5]  N. Parikh.  Advanced neuroimaging and its role in predicting neurodevelopmental outcomes in very preterm infants. , 2016, Seminars in perinatology.

[6]  G. Badger,et al.  Weight Growth Velocity and Postnatal Growth Failure in Infants 501 to 1500 Grams: 2000–2013 , 2015, Pediatrics.

[7]  I. Krägeloh-Mann,et al.  Growth, head growth, and neurocognitive outcome in children born very preterm: methodological aspects and selected results , 2015, Developmental medicine and child neurology.

[8]  B. Poindexter,et al.  Neuroimaging and Neurodevelopmental Outcome in Extremely Preterm Infants , 2015, Pediatrics.

[9]  S. Raz,et al.  Postnatal growth and neuropsychological performance in preterm-birth preschoolers. , 2014, Neuropsychology.

[10]  L. Lehtonen,et al.  Antenatal and Postnatal Growth and 5-Year Cognitive Outcome in Very Preterm Infants , 2014, Pediatrics.

[11]  P. Casey,et al.  Preterm infant linear growth and adiposity gain: trade-offs for later weight status and intelligence quotient. , 2013, The Journal of pediatrics.

[12]  V. Neubauer,et al.  Poor postnatal head growth in very preterm infants is associated with impaired neurodevelopment outcome , 2013, Acta paediatrica.

[13]  E. Demerath,et al.  The Relationship of Poor Linear Growth Velocity with Neonatal Illness and Two-Year Neurodevelopment in Preterm Infants , 2012, Neonatology.

[14]  Ken P Kleinman,et al.  Infant Growth Before and After Term: Effects on Neurodevelopment in Preterm Infants , 2011, Pediatrics.

[15]  K. Widhalm,et al.  Head circumference catch-up growth among preterm very low birth weight infants: effect on neurodevelopmental outcome , 2011, Journal of perinatal medicine.

[16]  E. Demerath,et al.  Body Composition Changes in Preterm Infants Following Hospital Discharge: Comparison With Term Infants , 2011, Journal of pediatric gastroenterology and nutrition.

[17]  L. D. de Vries,et al.  Postnatal growth of preterm born children ≤ 750g at birth. , 2011, Early human development.

[18]  Asta Ellingvåg,et al.  First year growth among very low birth weight infants , 2010, Acta paediatrica.

[19]  M. Kron,et al.  Intrauterine, Early Neonatal, and Postdischarge Growth and Neurodevelopmental Outcome at 5.4 Years in Extremely Preterm Infants After Intensive Neonatal Nutritional Support , 2009, Pediatrics.

[20]  J. Rigo,et al.  Extrauterine growth restriction in very‐low‐birthweight infants , 2004, Acta paediatrica.

[21]  Ross A. Thompson,et al.  Developmental science and the media. Early brain development. , 2001, The American psychologist.