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Early growth and development in low-birthweight infants following treatment in an intensive care nursery
Insights
Preterm infants born before 33 weeks showed sex-specific growth differences and neurological outcomes. Boys experienced more central nervous system defects, while girls exhibited slower initial weight gain but similar overall development.
Area of Science:
- Neonatology
- Pediatric Growth and Development
- Neurodevelopmental Pediatrics
Background:
- Premature infants born before 33 weeks gestation require careful monitoring for growth and neurodevelopmental outcomes.
- Previous studies indicate potential sex differences in the long-term effects of prematurity.
- Understanding these differences is crucial for optimizing care for very preterm infants.
Purpose of the Study:
- To compare the growth and neurodevelopmental outcomes of appropriate-for-date infants born before 33 weeks gestation with full-term controls.
- To investigate potential sex-based differences in growth trajectories and neurological development in this cohort.
- To assess the incidence of central nervous system defects in very preterm infants.
Main Methods:
- Longitudinal follow-up of 67 appropriate-for-date infants (gestation < 33 weeks) for 12 months post-term.
- Comparison of growth parameters (weight, length, head circumference, indices, velocity) with 24 full-term controls and standard growth charts.
- Assessment of central nervous system defects and developmental quotients.
Main Results:
- Boys showed no significant differences in growth parameters compared to controls or standards.
- Girls exhibited slower weight gain velocity in the first six months and lower weight indices at 12 months.
- Boys had a higher incidence of gross central nervous system defects (22.5%), primarily hydrocephaly, while girls had none.
- Mean post-conceptional developmental quotients were similar for both sexes (Boys: 108, Girls: 110).
Conclusions:
- Very preterm infants born before 33 weeks show sex-specific growth patterns, with girls experiencing initial slower weight gain.
- Boys are at a significantly higher risk for central nervous system defects, including hydrocephaly.
- Despite growth differences and higher neurological risks in boys, overall post-conceptional development appears comparable between sexes at 12 months corrected age.
Abstract:
Sixty-seven appropriate-for-date infants with gestations less than 33 weeks were followed for 12 months after their term dates. All had been born after September 1970. None received hypercaloric alimentation as neonates. Growth from the expected date of delivery was compared with that of 24 normal full-term infants and with accepted growth standards. The boys did not differ from the controls or the standard in mean weight, length, and head circumference, in weight and height indices, or in velocity of weight and linear growth. The girls had a slower velocity of weight growth for the first six months and had significantly lower weight indices at 12 months than did their controls. Velocity of linear growth, height indices, and mean length and head circumference for the girls were similar to those of the control standards. Gross central nervous system defects occurred in 22.5% of the boys but in none of the girls. More than one half of the abnormalities were hydrocephaly. The mean post-conceptional developmental quotient was 110 for the girls and 108 for the boys.