Antenatal and Postnatal Growth and 5-Year Cognitive Outcome in Very Preterm Infants

Abstract

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

The motor profile of preterm infants at 11 y of age

“…Another difference compared to previous literature was that no effect of gender or small for gestational age status on the motor performance was found (4,9,10). This is consistent with our previous results of similar outcomes in small for gestational age infants (20)(21)(22).…”

Growth after late-preterm birth and adult cognitive, academic, and mental health outcomes

“…Even though faster growth in infancy and childhood has been shown to benefit neurodevelopment in those born very preterm (<32 weeks) (9)(10)(11)(12), early preterm (<33 weeks) (13), preterm (14), and preterm with extremely low (<1000g) (15)(16)(17)(18) or very low (<1500g) (9,10,(19)(20)(21)(22) birth weight, in some, though not in all studies (23-25), it still remains unknown if faster early growth also benefits neurodevelopment in those born late-preterm. Accordingly, we examined if growth after late-preterm birth predicts neurocognitive functioning, academic performance, or mental health in individuals who were born latepreterm, and who participated in follow-up examinations at 5 and 20 months of corrected age (CA) and 56 months and 25 years of age.…”

Fetal and Postnatal Head Circumference Growth: Synergetic Factors for Neurodevelopmental Outcome at 2 Years of Age for Preterm Infants

“…Head circumference (HC) growth is strongly associated with neurodevelopmental outcome in preterm infants, from 18 months of corrected age to 5.5 years of age [7,8]. Previous data support the fact that HC catch-up growth has a significant beneficial effect on neuromotor scores and neurocognitive outcome [9,10].…”