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Growth During Infancy After Extremely Preterm Birth: Associations with Later Neurodevelopmental and Health Outcomes

T Michael O'Shea1, Hannah M Register1, Joe X Yi2

  • 1Department of Pediatrics, The University of North Carolina, Chapel Hill, NC.

The Journal of Pediatrics
|August 20, 2022
PubMed

Insights

Infants born extremely preterm who experienced rapid weight and length gains after neonatal intensive care unit discharge had higher obesity odds in early adolescence, particularly females. Growth changes did not significantly impact later neurocognitive or psychiatric outcomes.

Area of Science:

  • Neonatalogy
  • Pediatric Growth and Development
  • Longitudinal Health Outcomes

Background:

  • Extremely preterm birth poses risks for long-term health and development.
  • Infancy growth trajectories following neonatal intensive care unit (NICU) discharge may influence later life outcomes.
  • Understanding these associations is crucial for optimizing care for high-risk infants.

Purpose of the Study:

  • To investigate the relationship between infant growth changes (weight, length, weight/length ratio) after NICU discharge and later neurocognitive, psychiatric, and health outcomes.
  • To identify specific growth patterns associated with adverse outcomes in extremely preterm individuals.

Main Methods:

  • Analysis of data from the Extremely Low Gestational Age Newborn (ELGAN) study.
  • Measurement of weight and length at NICU discharge and at 2 years of age.
  • Evaluation of neurocognitive, psychiatric, and health outcomes at 10 and 15 years of age.
  • Multivariable logistic regression to assess associations between growth z-score changes and outcomes.

Main Results:

  • High gains in weight and weight/length ratio were linked to increased odds of obesity at 10 years, specifically in females.
  • High length gain was associated with lower obesity odds at 15 years.
  • High weight/length gain showed a modest association with lower odds of cognitive impairment at 10 years.

Conclusions:

  • Rapid infant growth post-NICU discharge in extremely preterm females is associated with higher obesity risk at 10 years.
  • Growth trajectories during the first two years after NICU discharge did not significantly predict neurocognitive or psychiatric outcomes in middle childhood and adolescence.
  • Further research is needed to understand the long-term implications of infant growth patterns in this vulnerable population.
Abstract

Keywords:
asthmagrowthneurodevelopmentobesitypreterm birth

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