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In Preterm Infants, Length Growth below Expected Growth during Hospital Stay Predicts Poor Neurodevelopment at 2

Laure Simon1,2, Camille Théveniaut1, Cyril Flamant1,2

  • 1Department of Neonatal Medicine, Nantes University Hospital, Nantes, France.

Neonatology
|May 31, 2018
PubMed

Insights

Neonatal length growth, unlike weight growth, can indicate growth quality in preterm infants. A significant deviation from expected length growth (∆OLG-ELG ≤-0.5) is linked to poorer neurodevelopmental outcomes at two years.

Area of Science:

  • Neonatology
  • Pediatric Neurology
  • Growth Monitoring

Background:

  • Neonatal weight growth in preterm infants correlates with neurodevelopment but poorly reflects growth quality.
  • Assessing growth quality is crucial for understanding long-term outcomes in vulnerable preterm populations.

Purpose of the Study:

  • To evaluate the association between neonatal length growth and neurodevelopmental outcomes at two years in preterm infants.
  • To determine if length growth deviation from expectation is a better indicator of growth quality than weight growth.

Main Methods:

  • Studied 2,403 preterm infants (gestational age < 34 weeks) from the LIFT cohort.
  • Calculated observed length growth (OLG) and expected length growth (ELG) Z-scores.
  • Assessed the difference (∆OLG-ELG) and its correlation with 2-year neurodevelopmental outcomes and body composition.

Main Results:

  • Expected length growth (ELG) was accurately predicted (R²=0.73).
  • Observed length growth (OLG) correlated with gestational age, but ∆OLG-ELG did not, suggesting independence from prematurity.
  • A ∆OLG-ELG ≤-0.5 Z-score was associated with increased odds of nonoptimal 2-year neurodevelopmental outcome (adjusted OR=1.56) and negatively correlated with fat mass.

Conclusions:

  • The difference between observed and expected length growth (∆OLG-ELG) serves as a gestational age-independent marker of neonatal growth quality.
  • A significant negative ∆OLG-ELG (≤-0.5 Z-score) indicates a higher risk for adverse neurodevelopmental outcomes at two years in preterm infants.
Abstract

Keywords:
Expected length growthNeurological outcomeObserved length growthPreterm infants

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