Early Extra-Uterine Growth Restriction in Very-Low-Birth-Weight Neonates with Normal or Mildly Abnormal Brain MRI: Effects on a 2-3-Year Neurodevelopmental Outcome

Nutrients. 2024 Feb 3;16(3):449. doi: 10.3390/nu16030449.

Abstract

Extra-uterine growth restriction (EUGR) is a common complication and a known risk factor for impaired development in very-low-birth-weight (VLBW) neonates. We report a population of 288 patients with no or with low-grade MRI lesions scanned at a term equivalent age (TEA) born between 2012 and 2018. Griffiths Mental Development Scale II (GMDS II) at 2 and 3 years, preterm complications and weight growth were retrospectively analyzed. EUGR was defined for weight z-score ˂ 10 percentile at TEA, 6 and 12 months of correct age or as z-score decreased by 1-point standard deviation (SDS) from birth to TEA and from TEA to 6 months. Multivariate analysis showed that a higher weight z-score at 6 months is protective for the global developmental quotient (DQ) at 2 years (OR 0.74; CI 95% 0.59-0.93; p = 0.01). EUGR at 6 months was associated with worse locomotor, personal/social, language and performance DQ at 2 years and worse language and practical reasoning DQ at 3 years. In conclusion, a worse weight z-score at 6 months of age seems to be an independent risk factor for significantly reduced GMDS in many areas. These results suggest that we should invest more into post-discharge nutrition, optimizing family nutritional education.

Keywords: EUGR; VLBW; extra-uterine growth restriction; neurodevelopment; nutritional education; preterm; weaning.

MeSH terms

  • Aftercare*
  • Birth Weight
  • Brain / diagnostic imaging
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature*
  • Infant, Very Low Birth Weight
  • Patient Discharge
  • Retrospective Studies

Grants and funding

Work supported by #NEXTGENERATIONEU (NGEU) and funded by Ministry of University and Researc (MUR), National Recovery and Resilience Plan (NRRP), project MNESYS (PE0000006)—A multiscale integrated approach to the study of nervous system in health and disease (DN.1553 11.10.2022).