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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Nonlinear relationship between early postnatal weight gain velocity and neurodevelopmental outcomes in very-low birth
Zhongchen Luo1, Beibei You1, You Zhang2
1School of Nursing, Guizhou Medical University, Guiyang, China.
Insights
Rapid weight gain in very-low birth weight preterm infants (VLBWPIs) shows nonlinear associations with neurodevelopmental impairment. Optimal growth patterns are key for neurodevelopment while minimizing risks of overnutrition.
Area of Science:
- Neonatalogy
- Developmental Pediatrics
- Public Health
Background:
- Extrauterine growth restriction in very-low birth weight preterm infants (VLBWPIs) is linked to poorer cognitive outcomes.
- Rapid infant weight gain in VLBWPIs increases risks for obesity and noncommunicable diseases.
- Research on early postnatal growth velocity and neurodevelopmental outcomes in VLBWPIs is limited and controversial.
Purpose of the Study:
- To investigate the association between early postnatal growth velocity and neurodevelopmental impairment (NDI) in VLBWPIs.
- To identify optimal growth patterns that support neurodevelopment and mitigate long-term health risks.
Main Methods:
- Secondary analysis of a prospective cohort of 1,791 VLBWPIs (birth weight <1500g).
- Evaluated weight gain velocity from birth to 24 months corrected age (CA) using binary logistic regression.
- Employed generalized additive models and penalized splines to analyze nonlinear relationships between growth velocity and NDI.
Main Results:
- Nonlinear associations were observed between NDI and weight gain velocity across different periods (birth to 6 months CA, 6 to 12 months CA, 12 to 24 months CA).
- Specific inflection points were identified, with varying odds ratios for NDI below and above these thresholds.
- The relationship between weight gain velocity and NDI demonstrated complex nonlinear patterns throughout early childhood.
Conclusions:
- Neurodevelopmental benefits of rapid weight gain in VLBWPIs may plateau after reaching an optimal growth velocity.
- Identifying growth patterns that optimize neurodevelopment while minimizing risks of overnutrition is crucial.
- Further research is needed to establish precise growth trajectories for improved long-term outcomes in VLBWPIs.
Background:
Extrauterine growth restriction among the very-low birth weight preterm infants (VLBWPIs) is associated with poorer cognitive development outcome, while the rapid weight gain in infancy increases the long-term risk of obesity and noncommunicable disease among VLBWPIs. However, the results of research on the association between early postnatal growth velocity and neurodevelopmental outcomes in VLBWPIs are still limited and controversial.
Objective:
We aimed to explore the association between the growth velocity in early postnatal and neurodevelopmental impairment (NDI) among VLBWPIs.
Methods:
This study was a secondary analysis of a previously published prospective cohort. It was based on data on 1,791 premature infants with a birth weight of less than 1500 g, registered in the database of the Premature Baby Foundation of Taiwan between 2007 and 2011. A binary logistic regression model was used to evaluate the association between the weight gain velocity in different periods [from birth to 6 months corrected age (CA), 6 to 12 months CA, and 12 to 24 months CA] and NDI, respectively. The generalized additive model and the smooth curve fitting (penalized spline method) were used to address nonlinearity, and a two-piece-wise binary logistic regression model was added to explain the nonlinearity further.
Results:
Nonlinearities were observed between NDI and the weight gain velocity from birth to 6 months CA [inflection point 20.36,
Conclusion:
The neurodevelopmental benefits from a rapid weight gain velocity from birth to 24 months CA might be limited once the growth pace reaches an optimum level. It would help find a pattern of growth that facilitates optimal neurodevelopment, yet minimizes negative health consequences associated with overnutrition further.
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