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Pattern of growth of very low birth weight preterm infants, assessed using the WHO Growth Standards, is associated

Andrea Nash1, Michael Dunn, Elizabeth Asztalos

  • 1Department of Nutritional Sciences, University of Toronto, Toronto, ON M5S 3E2, Canada.

Applied Physiology, Nutrition, and Metabolism = Physiologie Appliquee, Nutrition Et Metabolisme
|August 23, 2011
PubMed

Insights

Monitoring preterm infant growth with World Health Organization Growth Standards (WHO-GS) revealed that decelerated weight gain is linked to poorer neurodevelopment. Traditional CDC charts did not show this association, highlighting WHO-GS importance for preterm infant outcomes.

Area of Science:

  • Neonatalogy
  • Developmental Pediatrics
  • Growth Monitoring

Background:

  • Canadian organizations recommend World Health Organization Growth Standards (WHO-GS) for monitoring preterm infant growth post-discharge.
  • The efficacy of WHO-GS in predicting outcomes for preterm infants compared to traditional charts remains unevaluated.

Purpose of the Study:

  • To assess the association between growth patterns in very low birth weight (VLBW) preterm infants and neurodevelopmental outcomes up to 2 years corrected age.
  • To compare the utility of WHO-GS versus Centers for Disease Control and Prevention reference growth charts (CDC-RGC) in evaluating these associations.

Main Methods:

  • Classified growth patterns (sustained, decelerated, accelerated) for weight, length, and head circumference using WHO-GS and CDC-RGC in 289 VLBW infants from birth to 18-24 months corrected age.
  • Assessed neurodevelopment using the Bayley Scales of Infant and Toddler Development (BSID)-III at 18-24 months corrected age.
  • Analyzed associations between growth patterns and neurodevelopmental scores, adjusting for morbidities.

Main Results:

  • Using WHO-GS, a decelerated weight gain pattern was significantly associated with lower cognitive, language, and motor scores compared to sustained weight gain.
  • These associations remained significant after adjusting for infant morbidities.
  • No significant associations between growth patterns and neurodevelopmental outcomes were found when using the CDC-RGC.

Conclusions:

  • A decelerated weight gain pattern in VLBW preterm infants, as determined by WHO-GS, is linked to poorer neurodevelopmental outcomes.
  • The findings underscore the importance of using WHO-GS for growth monitoring in preterm infants to identify those at risk for developmental challenges.
  • CDC-RGC may not be sensitive enough to detect growth patterns associated with neurodevelopmental deficits in this population.

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