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Early postnatal growth variables are related to morphologic and functional ophthalmologic outcome in children born
M Hök-Wikstrand1, A-L Hård1, A Niklasson1
1Department of Ophthalmology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, SwedenDepartment of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Insights
Postnatal growth in very preterm children significantly impacts long-term vision. Early and later growth, along with insulin-like growth factor 1 (IGF-1) levels, correlate with visual acuity and head circumference.
Area of Science:
- Neonatalogy
- Ophthalmology
- Pediatric Growth
Background:
- Preterm birth (<32 weeks gestational age) poses risks for long-term health outcomes.
- Ophthalmologic complications are common in ex-preterm children.
- Postnatal growth patterns may influence neurodevelopmental and sensory outcomes.
Purpose of the Study:
- To investigate the relationship between gestational age (GA), early and late postnatal growth parameters, and ophthalmologic outcomes in ex-preterm children.
- To assess correlations between growth variables, insulin-like growth factor 1 (IGF-1) levels, and visual acuity, refractive errors, and visual perception at school age.
Main Methods:
- A cohort of 66 ex-preterm children (GA < 32 weeks) underwent ophthalmologic examinations at a median age of 5.6 years.
- Weight, height, and head circumference (HC) were measured and expressed as standard deviation scores (SDS).
- Statistical analyses explored associations between growth variables (neonatal and follow-up), GA, IGF-1 levels, and ophthalmologic findings.
Main Results:
- 74% of children had ophthalmologic abnormalities, and 17% had visual impairment.
- Poor visual acuity correlated with lower GA, lower early weight, and reduced weight, height, and HC at follow-up.
- Hyperopic children showed lower neonatal IGF-1 and HC at follow-up; poor visual perception was linked to low early weight and HC.
Conclusions:
- Early and later postnatal growth are critical determinants of visual acuity and perception in very preterm children.
- Neonatal IGF-1 concentrations and early growth are associated with head circumference and refractive status at follow-up.
- Monitoring growth and IGF-1 may aid in predicting and managing visual outcomes in this vulnerable population.
Aim:
To evaluate the association between gestational age (GA), early and late postnatal growth variables and ophthalmologic outcome in ex-preterm children. methods: Children (GA < 32 weeks, n = 66), previously examined regarding insulin-like growth factor 1 (IGF-1) serum concentrations in relation to ROP, underwent ophthalmologic examination at median 5.6 years. Weight, height, and head circumference (HC) were measured and expressed as SDS. Growth variables were analysed in relation to ophthalmologic outcome.
Results:
At follow-up 74% had some ophthalmologic abnormality and 17% had visual impairment. Poor visual acuity was correlated with low GA (r(s) = 0.29, p = 0.019), low weight at 32 weeks (r(s) = 0.30, p = 0.013), and low weight (r(s) = 0.37, p = 0.0025), height (r(s) = 0.41, p = 0.0007) and HC (r(s) = 0.55, p < 0.0001) at follow-up. Hyperopic children (25%) had low neonatal IGF-1 (p = 0.0096) and HC at follow-up (p = 0.022). Poor visual perception was correlated with low early weight (r(s) = 0.38, p = 0.0036) and HC at follow-up (r(s) = 0.39, p = 0.0024). Head circumference at follow-up was correlated with GA (r(s) = 0.40, p = 0.0012), neonatal IGF-1 (r(s) = 0.37, p = 0.0031), and early weight (r(s) = 0.27, p = 0.035).
Conclusions:
In very preterm children, early and later postnatal growth is closely related to visual acuity and perception at follow-up. In addition, IGF-1 concentrations and early growth are correlated with head circumference and refraction at follow-up.
