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Long-Term Neurodevelopmental and Functional Outcomes of Infants Born Very Preterm and/or with a Very Low Birth Weight

Jonneke J Hollanders1, Nina Schaëfer2, Sylvia M van der Pal3

  • 1Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands, j.hollanders@vumc.nl.

Neonatology
|March 6, 2019
PubMed

Insights

Birth weight is not a reliable proxy for gestational age in preterm infants. Very preterm infants without very low birth weight had better neurodevelopmental and functional outcomes at age 19.

Area of Science:

  • Neonatal studies
  • Developmental pediatrics
  • Public health

Background:

  • Birth weight (BW) is often used as a proxy for gestational age (GA) in preterm birth studies.
  • Subjects born very preterm (VP; GA < 32 weeks) and very low birth weight (VLBW; BW < 1,500 g) exhibit distinct postnatal growth patterns.
  • These differences extend beyond perinatal outcomes, impacting growth until final height.

Purpose of the Study:

  • To investigate neurodevelopmental and functional outcomes at age 19 in individuals born very preterm and/or with very low birth weight.
  • To determine if outcomes differ between VP and VLBW groups and their combinations.
  • To provide evidence for more precise inclusion criteria in future preterm infant research.

Main Methods:

  • A cohort of 705 19-year-olds from the Project on Preterm and Small-for-Gestational-Age Infants (POPS) was analyzed.
  • Participants were categorized into three groups: VP+/VLBW+, VP+/VLBW-, and VP-/VLBW+.
  • Outcomes assessed included IQ, neuromotor function, hearing, behavioral/emotional functioning, educational/occupational status, and self-assessed health.

Main Results:

  • VP+/VLBW- individuals showed higher IQ scores (3.8 points), better hearing (3.3 dB), and fewer behavioral issues compared to VP+/VLBW+.
  • VP-/VLBW+ individuals had increased odds (1.8x) of reporting poor health compared to VP+/VLBW+.
  • While statistically significant, effect sizes for these differences were generally small.

Conclusions:

  • Neurodevelopmental and functional outcomes at age 19 vary significantly among individuals born very preterm and/or with very low birth weight.
  • Gestational age and birth weight are not interchangeable indicators for preterm populations.
  • Future research, particularly in industrialized nations, should prioritize gestational age over birth weight for participant selection.
Abstract

Keywords:
AdolescentsBehaviorHealth statusIQLow gestational ageNeuromotor functioningPrematurity

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