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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

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Early growth and neurodevelopmental outcome in very preterm infants: impact of gender

A Frondas-Chauty1, L Simon2, B Branger3

  • 1Department of Neonatal Medicine, University Hospital of Nantes, Nantes, France INRA UMR 1280, Physiologie des Adaptations Nutritionnelles, IMAD, CRNH Ouest, Nantes, France.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|June 12, 2014
PubMed

Insights

Poor postnatal growth significantly impacts male preterm infant neurodevelopment more than females. This highlights gender-specific considerations for neonatal nutrition and care to improve long-term outcomes.

Area of Science:

  • Neonatology
  • Neurodevelopmental Pediatrics
  • Pediatric Nutrition

Background:

  • Neonatal nutrition critically influences neurological outcomes in very preterm infants.
  • Male preterm infants face higher risks of neonatal morbidity and adverse neurological outcomes compared to females.
  • Growth during hospitalization is a key factor in neonatal care, with potential gender-specific effects.

Purpose of the Study:

  • To investigate the differential impact of postnatal growth on neurodevelopmental outcomes between male and female very preterm infants.
  • To determine if gender modifies the association between hospital growth and neurological prognosis.
  • To identify potential targets for gender-tailored interventions in neonatal care.

Main Methods:

  • A cohort study of very preterm infants (gestational age <33 weeks) born between 2003-2009 was conducted.
  • Infant growth was assessed by weight z-score change from birth to discharge and categorized into five classes.
  • Neurodevelopmental outcome at 2 years corrected age was the primary endpoint, with odds ratios calculated for non-optimal outcomes by gender.

Main Results:

  • A significant interaction between gender and early growth on neurodevelopmental outcomes was observed (p=0.02).
  • Boys exhibited significantly higher odds ratios for non-optimal outcomes across poorer growth categories compared to girls.
  • For instance, a weight z-score change from <-2 to -0.50 to -0.01 showed adjusted ORs of 3.2-2.2 in boys versus 1.8-0.95 in girls.

Conclusions:

  • Male neurodevelopment in very preterm infants is markedly more sensitive to poor postnatal growth than female neurodevelopment.
  • These findings underscore the importance of considering infant gender in optimizing nutritional strategies to mitigate adverse neurological outcomes.
  • Gender-specific growth trajectories may be crucial for long-term neurological health in this vulnerable population.
Abstract

Keywords:
GrowthNeonatologyNeurodevelopmentNutritionOutcomes research

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