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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Trends in Preterm Body Composition and Neurodevelopmental Outcomes after Discharge

Laura E Lach1, Katherine E Chetta1, Mathew J Gregoski2

  • 1Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, USA.

Neonatology
|September 6, 2023
PubMed

Insights

Higher fat-free mass (FFM) in preterm infants is linked to better neurodevelopmental outcomes. Maternal milk at discharge also positively impacts cognitive and language scores in these infants.

Area of Science:

  • Neonatology
  • Pediatric Nutrition
  • Developmental Pediatrics

Background:

  • Preterm infant body composition, particularly fat-free mass (FFM), is crucial for neurodevelopmental outcomes.
  • Limited data exists on body composition changes in preterm infants post-discharge.
  • Air displacement plethysmography (ADP) is a method to assess body composition.

Purpose of the Study:

  • To investigate the association between body composition (FFM) and neurodevelopmental outcomes in preterm infants.
  • To examine body composition at inpatient and outpatient stages.
  • To explore the impact of maternal milk feeding at discharge on neurodevelopment.

Main Methods:

  • 510 preterm infants admitted to NICU had body composition measured by ADP.
  • 379 infants had anthropometrics, ADP scans (FFM, fat mass, fat percent z-scores), and neurodevelopmental testing (CAT/CLAMS, Peabody Gross Motor) at 4-6 months corrected age.
  • Multivariate analyses compared body composition measurements with neonatal factors and neurodevelopmental outcomes.

Main Results:

  • Infants had a mean gestational age of 32 ± 4.8 weeks and birth weight of 1,697 ± 932 g.
  • Positive correlations were found between FFM z-scores (inpatient and outpatient ADP) and cognitive, language, and gross motor scores (p < 0.05).
  • Maternal milk at discharge was associated with higher cognitive (β = 0.22) and language scores (β = 0.26).

Conclusions:

  • Increased FFM in preterm infants is associated with improved cognitive, language, and gross motor function.
  • Maternal milk feeding at discharge shows a positive association with cognitive and language development.
  • Body composition assessment and nutritional support are important for optimizing preterm infant neurodevelopment.
Abstract

Keywords:
Air displacement plethysmographyBody compositionNeonatal intensive care unitNeurodevelopmental outcomesPremature infants

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