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Neurodevelopmental outcomes in postnatal growth-restricted preterm infants with postnatal head-sparing

J M Meyers1, C M Bann2, B J Stoll3

  • 1Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|September 16, 2016
PubMed

Insights

Postnatal head-sparing (PHS) in extremely preterm infants improved motor scores at 2 years. However, PHS did not significantly impact cognitive scores or other neurodevelopmental outcomes in this growth-restricted group.

Area of Science:

  • Neonatology
  • Neurodevelopmental Pediatrics
  • Perinatal Medicine

Background:

  • Postnatal growth restriction is common in extremely preterm infants (<29 weeks).
  • Head-sparing (PHS) is a nutritional strategy aimed at preserving brain growth.
  • The long-term neurodevelopmental effects of PHS in this population are not fully understood.

Purpose of the Study:

  • To compare neurodevelopmental outcomes at 2 years of corrected age.
  • To assess the impact of PHS on growth-restricted infants born extremely preterm.
  • To evaluate cognitive and motor scores, cerebral palsy, and overall neurodevelopmental impairment.

Main Methods:

  • Analysis of developmental outcomes at 2 years in postnatally growth-restricted infants.
  • Comparison between infants with and without PHS.
  • Multivariate regression analysis adjusting for independent risk factors.

Main Results:

  • Of 658 growth-restricted infants, 301 received PHS.
  • Infants with PHS showed significantly higher adjusted Bayley III motor composite scores (mean difference 4.65, P<0.01).
  • No significant differences were observed in cognitive scores, cerebral palsy, or overall neurodevelopmental impairment.

Conclusions:

  • PHS is associated with improved motor outcomes in extremely preterm, growth-restricted infants.
  • The specific benefits of PHS on neurodevelopmental outcomes appear primarily related to motor function.
  • Further research is needed to understand the persistence of these effects later in life.
Abstract

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