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Effect of first-month head-size growth trajectory on cognitive outcomes in preterm infants

Wen-Hao Yu1, Shan-Tair Wang2, Li-Wen Chen1

  • 1Graduate Institutes of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Journal of the Formosan Medical Association = Taiwan Yi Zhi
|June 8, 2021
PubMed

Insights

Delayed head-size growth in preterm infants during the first month is linked to cognitive impairment. Monitoring head circumference (HC) growth trajectories can identify infants at higher risk for neurodevelopmental issues.

Area of Science:

  • Neonatal Neuroscience
  • Developmental Pediatrics
  • Pediatric Neurology

Background:

  • Head-size growth patterns in the first month post-birth may predict cognitive development.
  • Understanding these early growth trajectories is crucial for identifying infants at risk of cognitive impairment.

Purpose of the Study:

  • To investigate the association between head-size growth trajectory patterns in the first month of life and cognitive impairment at 24 months in very-preterm infants.
  • To identify specific neonatal risk factors influencing head circumference growth and subsequent cognitive outcomes.

Main Methods:

  • Retrospective cohort study of 403 very-preterm infants.
  • Group-based trajectory modeling analyzed weekly head circumference (HC) growth in the first month.
  • Cognitive outcomes assessed at 24 months using the Bayley Scales of Infant Development.

Main Results:

  • Three distinct head-size growth trajectory patterns were identified: delayed catch-up (31.5%), slow catch-up (54.0%), and fast catch-up (14.5%).
  • Delayed catch-up was significantly associated with a higher rate of cognitive impairment (19.5%) compared to fast catch-up (8.5%).
  • Gestational age, respiratory distress syndrome, and patent ductus arteriosus were significant neonatal risk factors impacting HC growth trajectories and cognitive outcomes.

Conclusions:

  • Delayed head-size catch-up growth in the first month is a key indicator of susceptibility to cognitive impairment in preterm infants.
  • Early monitoring of head circumference growth trajectories can aid in the early identification and management of neurodevelopmental risks in preterm infants.
Abstract

Keywords:
Cognitive outcomesGroup-based trajectory modellingHead size growthRisk factorsVery preterm infant

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