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Published on: March 28, 2025
Accelerated postnatal head growth follows preterm birth
J Cockerill1, S Uthaya, C J Doré
1Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NH. n.modi@imperial.ac.uk.
Insights
Preterm infants experienced poor weight gain but accelerated head growth. Breast milk intake positively impacted head growth, while illness severity negatively affected weight gain in premature babies.
Area of Science:
- Neonatalogy and Perinatal Medicine
- Pediatric Growth and Development
- Neurodevelopmental Outcomes
Background:
- Poor growth in preterm infants, especially head growth, is linked to neurodevelopmental issues.
- Understanding growth patterns is crucial for improving outcomes in premature babies.
Purpose of the Study:
- To assess weight gain and head growth in preterm infants from birth to term.
- To investigate the influence of breast milk intake and illness severity on growth.
Main Methods:
- Studied infants born at or before 32 weeks gestation, assessed up to 37 weeks postmenstrual age.
- Measured weight and head circumference (HC) as standard deviation scores (SDS).
- Quantified illness severity (%L1IC) and breast milk exposure (%BM) relative to total days.
Main Results:
- Infants showed significant weight decline (SDS from -0.31 to -1.32) but significant head growth (SDS from -0.52 to -0.03).
- Higher illness severity (%L1IC) correlated with poorer weight gain (SDSG).
- Greater breast milk intake (%BM) correlated with improved head growth (SDSG).
Conclusions:
- Accelerated postnatal head growth may indicate catch-up from intrauterine constraints.
- Breast milk may promote postnatal head growth, suggesting a need for optimized feeding strategies.
- Illness severity significantly impacts weight gain in preterm infants.
Background:
Poor growth after preterm birth, particularly poor head growth, is associated with impaired neurodevelopmental outcome.
Objective:
To evaluate weight gain and head growth between birth and term in a contemporary cohort of preterm infants, taking into account breast milk intake and illness severity.
Methods:
Subjects were inborn infants
Results:
Infants showed poor postnatal weight gain but accelerated head growth. There was a highly significant fall in mean (SD) weight SDS between birth and discharge (-0.31 (0.96) and -1.32 (1.02) respectively, p<0.001) and a highly significant increase in HC SDS (-0.52 (0.95) and -0.03 (1.25) respectively, p = 0.003). %L1IC had a highly significant negative impact on weight SDSG (p = 0.006), and %BM had a significant positive impact on HC SDSG (p = 0.043).
Conclusions:
Accelerated postnatal head growth suggests catch up after antenatal restraint. This raises the possibility that poor neurocognitive outcomes after extremely preterm birth may in part be consequent on poor intrauterine brain growth. As postnatal head growth may be facilitated by breast milk, there is an urgent need to evaluate the optimal use of breast milk in preterm neonates. Illness severity is a significant determinant of poor postnatal weight gain.
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