Association of Postnatal Growth Changes and Neurodevelopmental Outcomes in Preterm Neonates of <29 Weeks’ Gestation - 05/05/23
for the
Canadian Neonatal Network and Canadian Neonatal Follow-Up Network Investigators
Abstract |
Objective |
To examine associations between weight and head circumference (HC) changes and neurodevelopment in preterm infants.
Study design |
This retrospective cohort study of Canadian Neonatal Network and Canadian Neonatal Follow-Up Network sites included preterm infants born 2010-2018. Logistic regression and model diagnostics evaluated relationships between changes in z score and velocity of weight and HC from birth to discharge from a tertiary neonatal intensive care unit, discharge to 18-24 months corrected age (CA), and birth to 18-24 months CA and significant cognitive/motor impairment at 18-24 months CA classified using a Bayley Scales of Infant and Toddler Development-Third Edition cognitive or motor composite score <70.
Results |
In total, 4530 infants (53.0% male) with a mean (SD) gestational age of 26.3 (1.4) weeks and birth weight of 920 (227) g were included. Weight and HC changes were associated with lower odds of significant cognitive/motor impairment including an OR of 0.87 (95% CI: 0.83, 0.91; P < .001) for a 1-g/d increase in weight from discharge to 18-24 months CA and 0.81 (95% CI: 0.75, 0.88; P < .001) for a 1-unit increase in HC z score from birth to 18-24 months CA. Associations were not statistically significant in morbidity-free neonates. Weight and HC gains poorly discriminated between infants with and without significant cognitive/motor impairment (areas under the receiver operating characteristic curve of <0.64). No growth measure had a clinically useful balance of sensitivity and specificity.
Conclusions |
Weight and HC changes were associated with significant cognitive/motor impairment but had poor discriminatory capability. Neonatal morbidities may make a larger contribution than postnatal growth to neurodevelopment.
Le texte complet de cet article est disponible en PDF.Keywords : preterm infant, discharge, weight, head circumference, neurodevelopment
Abbreviations : AUROC, Bayley-III, CA, CNFUN, CNN, HC, NICU, ROC, SNAP-II
Plan
| N.B. is supported by funding from the Canadian Institutes of Health Research (#FDN143233 [to D.O., S.U.]) and a University of Toronto Ontario Graduate Scholarship. The sources of funding had no role in the study design; the collection, analysis, and interpretation of data; the writing of the report; or the decision to submit the paper for publication. The authors declare no conflicts of interest. |
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| Preliminary results were presented at the April 6-7, 2022 CNN-CPTBN Virtual Annual Meeting. |
Vol 256
P. 63 - mai 2023 Retour au numéro
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