WHAT'S KNOWN ON THIS SUBJECT: Better postnatal growth, especially head growth, associates with better cognitive development in preterm infants. Suboptimal postnatal growth is more common in infants with poor antenatal growth than in infants with normal growth. WHAT THIS STUDY ADDS:Good weight gain and head circumference growth until 2 years was associated with better 5-year cognitive outcome in non-small for gestational age infants. Good head circumference growth around term age benefits the cognitive outcome of small for gestational age infants. abstract OBJECTIVES: To study how antenatal growth affects cognitive outcome in very preterm infants and to determine whether there is an association between growth in any particular time period between birth and 5 years of age and cognitive outcome. Small for gestational age (SGA) and non-SGA infants were analyzed separately, because antenatal growth may affect postnatal growth. and 2006 who were treated at Turku University Hospital (n = 181) were followed. Weight, length, and head circumference (HC) of the infants were measured at 9 time points between birth and 5 years. The growth was determined as a z score change between measurement points. Cognitive development was assessed at 5 years of age with the Wechsler Preschool and Primary Scales of IntelligenceRevised. The association between growth and full-scale IQ (FSIQ) was studied. METHODS:RESULTS: Growth in length and height was not associated with 5-year cognitive outcome. However, weight (r = 0.18, P = .04) and HC growth (r = 0.25, P = .01) between birth and 2 years of corrected age correlated to FSIQ in non-SGA children. In SGA children, HC growth (r = 0.33, P = .03) around term age correlated to FSIQ. CONCLUSIONS:Cognitive outcome was similar in SGA and non-SGA very preterm infants. Growth affected cognition positively in both subgroups, but the critical time period was different. Drs Leppänen and Lind made substantial contributions to conception and design, acquired data, analyzed and interpreted data, and wrote and revised the manuscript; Drs Lapinleimu, Lehtonen, Haataja, and Rautava made substantial contributions to conception and design, analyzed and interpreted data, and wrote and revised the manuscript; Mr Matomäki carried out the statistical analyses, made substantial contributions to conception and design and interpretation of data, and wrote and revised the manuscript; and all authors approved the article to be published. www.pediatrics.org/cgi

Objective To study neurodevelopmental outcome at 2 years of corrected age in very-low-birth-weight (VLBW) (≤ 1500 g) preterm infants with abnormal fetoplacental flow. Methods

Straightforward synthesis for two pentaerythrityltetramine precursors, 2,2-bis(azidomethyl)propane-1,3-diamine (1) and 2-[N-(allyloxycarbonyl)aminomethyl]-2-azidomethylpropane-1,3-diamine (2), has been described. Both propane-1,3-diamines have been attached by reductive amination to a solid-supported backbone amide linker derived from 4-(4-formyl-3,5-dimethoxyphenoxy)butyric acid. The presence of the two methoxy substituents on the linker is essential to avoid cross-linking between two linkers. The remaining free primary amino group of the propane-1,3-diamine moiety may then be selectively acylated with an appropriately protected amino acid using conventional N,N-dicyclohexylcarbodiimide/1-hydroxybenzotriazole (DCC/HOBt) activation without any interference by the secondary amino function. The latter group may be subsequently acylated by an anhydride method. Sequential reduction of the azido group and removal of the allyloxycarbonyl protection from 2 allow further coupling of two different amino acids, and hence, this handle may be utilized in construction of branched structures containing four different amino acids or peptides. Solid-supported 1 may, in turn, be used for the synthesis of similar constructs containing two identical branches. It is worth noting that no acid-labile protecting groups are required in this approach, and hence, this dimension may be saved for the cleavage of the linker. The applicability of the scaffolds to library synthesis has been demonstrated by preparation of 11 pentaerythrityl-branched tetra- and octapeptides.

Growth-restricted infants seem to have delayed brain maturation that is not fully compensated at term, despite catch-up growth.