Growth in very preterm children: Head growth after discharge is the best independent predictor for cognitive outcome

Early Hum Dev. 2016 Dec:103:183-188. doi: 10.1016/j.earlhumdev.2016.09.016. Epub 2016 Oct 5.

Abstract

Background: The contribution of growth parameters to the cognitive outcome of very low birth weight (VLBW)/very preterm (VP) infants is difficult to disentangle from other preterm-birth related factors.

Aims: We hypothesized that long-term cognitive and motor outcome of VLBW/VP infants is most strongly associated with growth in head circumference after hospital discharge.

Study design: Single-centre prospective longitudinal study: anthropometric measures at different time points (birth, discharge, school-age).

Subjects: 136 VLBW/VP infants (<32weeks gestation/birth weight<1.500g).

Outcome measures: Cognitive and motor function (Kaufman Assessment Battery for Children; Movement Assessment Battery for Children) at school-age (6.7-10.0years, mean=8.2).

Results: In hierarchical multiple regression analyses, growth from birth to discharge significantly predicted cognitive outcome (weight: R2change=0.063, p=0.014; length: R2change=0.078, p=0.007; HC: R2change=0.050, p=0.030), as well as weight gain (R2change=0.096, p=0.001) and head growth (R2change=0.134, p<0.001) from discharge to school-age. While most growth parameters, especially those from birth to discharge, were significantly influenced by prenatal growth and immaturity related morbidity (R2=0.151 to 0.605, all p≤0.001), head growth after discharge was not (R2=0.029, p=0.461).

Conclusions: Amongst all anthropometric measures, head growth between discharge and school-age is the best independent predictor for cognitive outcome in VLBW/VP infants. Determinants of head growth after discharge need further studies to identify targets for intervention.

Keywords: Child development; Cognitive development; Head growth; Preterm infants.

MeSH terms

  • Adult
  • Child
  • Child Development*
  • Cognition*
  • Developmental Disabilities / diagnosis
  • Developmental Disabilities / epidemiology*
  • Female
  • Head / anatomy & histology
  • Head / growth & development*
  • Humans
  • Infant, Newborn
  • Infant, Premature / growth & development*
  • Infant, Very Low Birth Weight / growth & development*
  • Male