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Neuropsychological Development and New Criteria for Extrauterine Growth Restriction in Very Low-Birth-Weight Children
Leticia Alcántara1, Cristina Fernández-Baizán2, Lara González-García1
1Hospital Universitario Central de Asturias, Universidad de Oviedo, 33003 Oviedo, Spain.
Insights
Neonatal growth in very low birth-weight preterm infants shows a limited link to neurodevelopmental outcomes. Current extrauterine growth restriction criteria do not enhance prediction of these results.
Area of Science:
- Neonatalogy
- Neurodevelopmental Pediatrics
- Pediatric Growth Assessment
Background:
- The relationship between neonatal growth and neurodevelopment in very low birth-weight preterm infants is debated.
- Changes in extrauterine growth restriction (EUGR) criteria may influence observed outcomes.
Purpose of the Study:
- To evaluate if new EUGR criteria alter the association between existing criteria and neurodevelopmental test results in preterm children.
- To assess the predictive value of neonatal growth parameters on cognitive function.
Main Methods:
- Studied 87 very low birth-weight preterm infants aged 5-7 years.
- Administered the Reynolds Intellectual Screening Test (RIST) and NEPSY-II for neurodevelopmental assessment.
- Analyzed correlations between neonatal growth z-scores (Fenton, INTERGROWTH-21st) and cognitive test results.
Main Results:
- The RIST index correlated with neonatal weight and length z-scores (Fenton and INTERGROWTH-21st).
- No significant correlation was found between growth z-scores and NEPSY-II subtask performance.
- Neonatal growth differences from birth to discharge did not correlate with cognitive outcomes.
Conclusions:
- Neonatal growth appears to have a limited, though present (for RIST), impact on neurodevelopmental outcomes at primary school age.
- Current extrauterine growth restriction criteria do not offer improved predictive ability for neurodevelopmental outcomes compared to older criteria.
Background:
Controversy between short-term neonatal growth of very low birth-weight preterm (VLBW) and neurodevelopment may be affected by criteria changes of extrauterine growth restriction (EUGR).
Objective:
to determine if new EUGR criteria imply modifications in the relationship between old criteria and results of neuropsychological tests in preterm children.
Patients And Methods:
87 VLBW at 5-7 years of age were studied. Neuropsychological assessment included RIST test (Reynolds Intellectual Sctreening Test) and NEPSY-II (NE neuro, PSY psycolgy assessment) tests. The relationships between these tests and the different growth parameters were analyzed.
Results:
RIST index was correlated with z-score Fenton's weight (p = 0.004) and length (p = 0.003) and with z-score IGW-21's (INTERGRWTH-21 Project) weight (p = 0.004) and length (p = 0.003) at neonatal discharge, but not with z-score difference between birth and neonatal discharge in weight, length, and HC for both. We did not find a statistically significant correlation between Fenton or IGW-21 z-scores and scalar data of NEPSY-II subtasks.
Conclusion:
In our series, neonatal growth influence on neuropsychological tests at the beginning of primary school does not seem robust, except for RIST test. New EUGR criteria do not improve the predictive ability of the old ones.
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