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Poor Head Growth Is Associated with Later Mental Delay among Vietnamese Preterm Infants: A Follow-up Study
Chuong Huu Thieu Do1, Malene Landbo Børresen2, Freddy Karup Pedersen2
1Neonatal Intensive Care Unit, Children's Hospital 1, Ho Chi Minh City, Vietnam.
Insights
Vietnamese preterm infants show early weight catch-up but lagging head growth. Poor head circumference growth is linked to increased odds of mental delay, highlighting the need for close monitoring.
Area of Science:
- Pediatrics
- Neonatology
- Developmental Pediatrics
Background:
- Preterm infants in low- and middle-income countries face significant risks for poor physical growth.
- Growth data for these vulnerable populations remain limited, hindering effective interventions.
Purpose of the Study:
- To characterize the physical growth of Vietnamese preterm infants over the first two years of life.
- To compare their growth trajectories with World Health Organization (WHO) standards and healthy Southeast Asian (SEA) infants.
- To investigate the association between early growth patterns and neurodevelopmental outcomes at corrected age (CA) of 24 months.
Main Methods:
- A cohort study followed preterm infants post-discharge from neonatal intensive care units for two years.
- Key anthropometric measurements (weight, length, head circumference) were recorded at 3, 12, and 24 months CA.
- Neurodevelopment was assessed at 24 months CA using the Bayley Scales of Infant and Toddler Development-3rd Edition.
Main Results:
- Over 90% of infants demonstrated catch-up weight by 3 months CA.
- Weight and length were comparable to healthy SEA infants but below WHO standards.
- Head circumference (HC) was significantly smaller than WHO standards, with Z-scores declining from -0.95 at 3 months to -1.50 at 24 months CA.
- A one-unit decrease in HC Z-score between 3 and 12 months CA was associated with a nearly twofold increase in the odds of mental delay at 24 months CA (OR 1.89).
Conclusions:
- Vietnamese preterm infants exhibit rapid initial weight gain but demonstrate suboptimal head growth.
- Poor head growth in early infancy is a significant predictor of later mental developmental delays.
- Head circumference monitoring is crucial for the follow-up and early identification of potential neurodevelopmental issues in preterm infants.
Background:
Preterm infants in low- and middle-income countries are at high risk of poor physical growth, but their growth data are still scarce.
Objectives:
To describe the growth of Vietnamese preterm infants in the first 2 years, and to compare with references: World Health Organization (WHO) child growth standards, and healthy Southeast Asian (SEA) infants. Further, to assess the association between growth in the first year and neurodevelopment at 2 years corrected age (CA).
Methods:
We conducted a cohort study to follow up preterm infants discharged from a neonatal intensive care unit for 2 years. Weight, length and head circumference (HC) were measured at 3, 12 and 24 months CA. Neurodevelopment was assessed using Bayley Scales of Infant and Toddler Development-3rd Edition at 24 months CA.
Results:
Over 90% of the cohort showed catch-up weight at 3 months CA. Weight and length were comparable to healthy SEA but were lower than WHO standards. HC was significantly smaller than those of WHO standards with HC Z-scores steadily decreasing from -0.95 at 3 months CA to -1.50 at 24 months CA. Each one decrement of HC Z-score from 3 to 12 months CA was associated with nearly twice an increase in odds of mental delay at 24 months CA (odds ratio 1.89; 95% confidence interval 1.02-3.50).
Conclusion:
Vietnamese preterm infants exhibited early catch-up weight but poor head growth, which was associated with later delays in mental development. Our findings support the importance of HC measures in follow-up for preterm infants.
