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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Post-natal growth of 157 children born as extremely premature neonates
Jitka Kytnarova1, Blanka Zlatohlavková, Ales Kubena
1Department of Pediatrics, First Faculty of Medicíne, Charles University in Prague, Prague, Czech Republic.
Insights
Extremely premature neonates show improved postnatal growth but remain shorter than controls. Head growth declines, increasing microcephaly risk by age five, highlighting the need for long-term monitoring.
Area of Science:
- Neonatalogy
- Pediatric Growth and Development
- Public Health
Background:
- Increasing survival rates of extremely premature neonates necessitate understanding their long-term health outcomes.
- Growth patterns and risk factors for later disorders in this population require thorough evaluation.
Purpose of the Study:
- To prospectively assess anthropometric parameters in children born extremely prematurely.
- To identify growth trajectories and potential health risks in this vulnerable group.
Main Methods:
- Anthropometric measurements (height, head circumference, waist/hip circumference, skinfolds) were taken at 2 and 5 years.
- Study included 72 neonates born between 22-25+6 weeks gestation (Group I) and 85 neonates born between 26-27+6 weeks gestation (Group II).
- Comparison made with a control population.
Main Results:
- Both groups exhibited catch-up postnatal growth, but height remained significantly lower than controls at 2 and 5 years (P < 0.01).
- A decline in head growth was observed between ages 2 and 5, leading to decreased head circumference standard deviation scores (SDS).
- Microcephaly (HC < -2 SD) increased, affecting 18% in Group I and 11.7% in Group II by age five. Waist/hip circumferences and skinfolds showed no significant differences between groups at age five.
Conclusions:
- Long-term follow-up of extremely premature neonates is crucial for understanding growth patterns.
- Assessment of growth parameters, including adiposity, aids in identifying risk factors for adult-onset diseases.
- Early identification of growth deviations like microcephaly is essential for timely intervention.
Aim:
With increasing survival rate of extremely premature neonates, their long-term outcomes including growth and risk factors for later disorders need to be considered. We prospectively evaluated anthropometric parameters in children born as extremely premature neonates.
Methods:
Anthropometric parameters were measured at the ages of 2 and 5 years in 72 extremely premature children born between the 22nd and 25 + 6th weeks of gestation (group I) and 85 children born between the 26th and 27 + 6th weeks of gestation (group II).
Results:
Although catch-up in the postnatal growth was observed in both groups of children, resulting in growth improvement, the height of the extremely premature children at the ages of 2 and 5 years remains lower (P < 0.01) compared with the control population. A decline in head growth was observed in both groups between the ages of 2 and 5 years, resulting in decrease of standard deviation score (SDS) for head circumference (HC) in comparison with that of the control population, accompanied by an increased number of children with microcephaly, defined as HC < -2 SD. At the age of five, microcephaly was found in 18% of children from group I and 11.7% of children from group II. At the age of 5 years, the waist and hip circumferences and ten skinfolds were not different between both groups of children.
Conclusion:
Long-term follow-up of extremely premature neonates is important not only to establish their growth patterns but also for risk factors assessment including adiposity for later development of adult-onset diseases.
