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Association of Growth During Infancy with Neurodevelopment and Obesity in Children Born Very Preterm: The

T Michael O'Shea1, Elizabeth T Jensen2, Joe X Yi1

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

The Journal of Pediatrics
|April 19, 2024
PubMed

Insights

Rapid weight gain after neonatal intensive care unit (NICU) discharge is linked to higher obesity risk. Slow weight gain is associated with poorer cognitive and language outcomes in preterm infants.

Area of Science:

  • Pediatrics
  • Neonatology
  • Developmental Pediatrics

Background:

  • Infants born very preterm face unique challenges in growth and development post-neonatal intensive care unit (NICU) discharge.
  • Understanding infant growth trajectories is crucial for predicting long-term health and developmental outcomes.

Purpose of the Study:

  • To investigate the association between weight gain patterns after NICU discharge and neurodevelopmental outcomes and obesity risk.
  • To identify critical growth periods influencing later childhood development in very preterm infants.

Main Methods:

  • A secondary analysis of the Environmental influences on Child Health Outcomes cohort included 1400 very preterm infants.
  • Weight z score change was calculated from NICU discharge to a mean follow-up of 27 months.
  • Neurodevelopmental outcomes were assessed using standardized tests; multivariable regression analyzed growth associations.

Main Results:

  • Very low weight gain (<-1.67 z score change) was linked to lower cognitive and language scores.
  • Very high weight gain (>1.67 z score change) was associated with a significantly increased risk of obesity (RR: 6.20).
  • Very high weight gain did not show an association with neurodevelopmental outcomes.

Conclusions:

  • Excessive weight gain in early infancy post-NICU discharge increases obesity risk.
  • Inadequate weight gain is associated with impaired cognitive and language development in very preterm children.
  • Monitoring infant growth trajectories after NICU discharge is vital for optimizing developmental and health outcomes.
Abstract

Keywords:
autistic disorderbehaviordevelopmental outcomesextremely premature infantvery preterm birthweight gain

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