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Associations between body weight trajectories and neurodevelopment outcomes at 24 months corrected age in
Ts-Ting Wang1,2, Yen-Ju Chen2, Yi-Han Su2
1Department of Pediatrics, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan.
Insights
A low-declining body weight trajectory in infants born very-low-birth-weight (VLBW) and cystic periventricular leukomalacia (cPVL) are linked to neurodevelopmental impairments. Early weight patterns and health conditions predict later outcomes in VLBW infants.
Area of Science:
- Neonatalogy
- Developmental Pediatrics
- Public Health
Background:
- Very-low-birth-weight (VLBW) infants face risks for adverse neurodevelopmental outcomes.
- Monitoring growth trajectories is crucial for identifying at-risk infants.
Purpose of the Study:
- To investigate the association between body weight (BW) z-score trajectories from birth to 6 months corrected age (CA) and neurodevelopmental outcomes at 24 months CA in VLBW infants.
- To identify specific weight patterns predictive of neurodevelopmental impairment (NDI).
Main Methods:
- Population-based retrospective cohort study of 3,334 VLBW infants (23-32 weeks gestation) across 21 Taiwanese hospitals.
- Group-based trajectory modeling identified distinct BW z-score trajectories.
- Multivariable logistic regression analyzed associations between trajectories, postnatal comorbidities (including cystic periventricular leukomalacia - cPVL), and NDI at 24 months CA.
Main Results:
- Three distinct BW z-score trajectories were identified: high-climbing, mid-declining, and low-declining.
- A low-declining trajectory was significantly associated with NDI (aOR: 2.59; p < 0.001).
- Cystic periventricular leukomalacia (cPVL) was also strongly associated with NDI (aOR: 3.59; p < 0.001).
Conclusions:
- A low-declining body weight trajectory from birth to 6 months CA is a significant predictor of neurodevelopmental impairment in VLBW infants.
- The presence of cPVL further increases the risk of NDI.
- Monitoring early weight gain patterns and addressing conditions like cPVL are vital for improving neurodevelopmental outcomes in VLBW infants.
Introduction:
This study aimed to explore the relationship between the trajectories of body weight (BW) z-scores at birth, discharge, and 6 months corrected age (CA) and neurodevelopmental outcomes at 24 months CA.
Methods:
Conducted as a population-based retrospective cohort study across 21 hospitals in Taiwan, we recruited 3,334 very-low-birth-weight (VLBW) infants born between 2012 and 2017 at 23-32 weeks of gestation. Neurodevelopmental outcomes were assessed at 24 months CA. Instances of neurodevelopmental impairment (NDI) were defined by the presence of at least one of the following criteria: cerebral palsy, severe hearing loss, profound vision impairment, or cognitive impairment. Group-based trajectory modeling was employed to identify distinct BW z-score trajectory groups. Multivariable logistic regression was used to assess the associations between these trajectories, postnatal comorbidity, and neurodevelopmental impairments.
Results:
The analysis identified three distinct trajectory groups: high-climbing, mid-declining, and low-declining. Significant associations were found between neurodevelopmental impairments and both cystic periventricular leukomalacia (cPVL) [with an adjusted odds ratio (aOR) of 3.59; p < 0.001] and belonging to the low-declining group (aOR: 2.59; p < 0.001).
Discussion:
The study demonstrated that a low-declining pattern in body weight trajectory from birth to 6 months CA, along with cPVL, was associated with neurodevelopmental impairments at 24 months CA. These findings highlight the importance of early weight trajectory and specific health conditions in predicting later neurodevelopmental outcomes in VLBW infants.
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