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Differential Effect of Growth on Development between AGA and SGA Preterm Infants
In Gyu Song1, Ee-Kyung Kim2, Hannah Cho3
1National Hospice Center, National Cancer Center, Goyang-si 10408, Korea.
Insights
Head circumference growth in preterm infants predicts neurodevelopmental outcomes. Specific growth patterns in appropriate-for-gestational-age infants indicate better cognitive development, while small-for-gestational-age infants rely on birth weight for outcomes.
Area of Science:
- Neonatology
- Developmental Pediatrics
- Pediatric Growth Monitoring
Background:
- Accurate prediction of neurodevelopmental outcomes is crucial for preterm infants, especially in resource-limited settings.
- Physical growth measurements offer a potentially accessible method for assessing neurodevelopmental trajectories.
- Identifying key growth indicators can guide early interventions and improve long-term outcomes for very preterm infants.
Purpose of the Study:
- To identify specific physical growth measures that correlate with neurodevelopmental outcomes in very preterm infants.
- To differentiate growth indicators between appropriate-for-gestational-age (AGA) and small-for-gestational-age (SGA) preterm infants.
- To establish the predictive value of head circumference (HC) and its growth for neurodevelopment.
Main Methods:
- Longitudinal study including preterm infants (<32 weeks gestation or <1500g).
- Calculation of z-scores for weight, length, and HC at birth, 35 weeks postmenstrual age (PMA), and 4 and 18 months corrected age (CA).
- Linear regression analysis to examine the relationship between growth parameters and Bayley-III neurodevelopmental scores.
Main Results:
- In appropriate-for-gestational-age (AGA) infants, HC at 4 months CA and HC growth between 35 weeks PMA and 4 months CA positively correlated with Bayley-III scores.
- Weight and length increases from birth to 18 months CA were also associated with better development in AGAs.
- For small-for-gestational-age (SGA) infants, only birth weight z-score predicted improved neurodevelopmental outcomes.
Conclusions:
- Head circumference at 4 months corrected age is a significant indicator of favorable neurodevelopment in preterm AGA infants.
- Head growth velocity between 35 weeks PMA and 4 months CA further contributes to positive neurodevelopmental outcomes in this group.
- Monitoring strategies for growth and neurodevelopment should be tailored differently for AGA and SGA preterm infants.
Abstract:
Predicting developmental outcomes with growth measurement would be beneficial for primary healthcare or in developing countries with low medical resources. This study aimed to identify physical growth measures that indicate neurodevelopment in very preterm infants. Preterm infants, born at <32 weeks' gestation or weighing <1500 g, were included. We calculated the changes in z-score of weight, length, and head circumference (HC) at different time points: birth, postmenstrual age (PMA) 35 weeks, and 4 and 18 months corrected age (CA). We examined the relationship between growth and Bayley-III scores using linear regression. Among 122 infants, HC at 4 months CA and HC growth between PMA 35 weeks and 4 months CA showed a positive correlation with Bayley-III scores in appropriate-for-gestational-age infants (AGAs). Weight and length increases between birth and 18 months CA were also associated with AGAs' development. In small-for-gestational-age infants (SGAs), only birthweight's z-score was associated with improved neurodevelopmental outcomes. HC at 4 months CA was an important indicator of favorable neurodevelopmental outcomes, and head growth spurt between PMA 35 weeks and 4 months CA contributed to this benefit in preterm AGAs. The period and indices should be monitored differently for SGAs and AGAs.
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