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Published on: August 25, 2014
Assessment of Post-Discharge Growth Pattern After Initial Growth Faltering and Its Association with the
Ariadna Witte Castro1, Celia Diaz Gonzalez1, Susana Ares Segura1
1Neonatology, Hospital La Paz Institute for Health Research, IdiPaz, 28046 Madrid, Spain.
Insights
Growth faltering (GF) in preterm infants is linked to delayed growth and lower neurodevelopmental scores up to two years corrected age. Early identification and intervention are crucial for improving long-term outcomes in these vulnerable infants.
Area of Science:
- Neonatalogy
- Pediatric Growth
- Neurodevelopmental Pediatrics
Background:
- Preterm infants face significant risks for growth faltering by term age.
- Post-discharge growth trajectories and neurodevelopmental outcomes in these infants require thorough investigation.
Purpose of the Study:
- To assess post-discharge growth patterns in preterm infants.
- To investigate the association between growth faltering and neurodevelopmental outcomes.
Main Methods:
- Cohort study comparing preterm infants with growth faltering (GF) and without (NGF).
- Growth assessed by weight z-score changes from birth to 36 weeks postmenstrual age (PMA) and up to 2 years corrected age (CA).
- Neurodevelopment evaluated using Parent Report of Children's Abilities-Revised (PARCA) and Bayley-III test.
Main Results:
- Growth faltering infants showed persistent weight deficits compared to birth z-scores up to 2 years CA.
- NGF infants demonstrated catch-up growth, achieving birth z-scores by 1 year CA.
- GF infants scored lower in language development (PARCA) and motor development (Bayley-III) at 2 years CA.
Conclusions:
- Growth faltering in preterm infants is associated with sustained growth differences until 2 years corrected age.
- Growth faltering is linked to impaired neurodevelopmental outcomes, including language and motor skills.
- These findings highlight the importance of monitoring growth and neurodevelopment in preterm infants post-discharge.
Background:
Preterm infants are at risk of growth faltering at term age. Our primary objective is to assess post-discharge growth patterns in these infants and investigate the association between growth faltering and neurodevelopment.
Methods:
We divided the sample into two groups according to growth during the initial hospital stay: infants who suffered from growth faltering (GF, loss of >1 weight z-score from birth to 36 weeks postmenstrual age, n = 115) and infants who did not suffer from GF (non-growth faltering, NGF, n = 85).
Results:
The NFG group weight z-score was significantly lower at 36 postmenstrual ages (PMA) compared to birth (p < 0.001), at 1-year corrected age (CA), it was significantly higher than at birth (p = 0.0026), and by 2 years CA, there were no differences compared to the birth z-scores. In the GF infants' group, statistical differences were found at all time points. At 3 and 6 months, CA GF infants were still in weight z-score values lower than -1 point compared to the birth median value. At 12 and 24 months CA, they still had not achieved birth z-score values (p < 0.001). In the Parent Report of Children's Abilities-Revised (PARCA), NGF infants had a higher score in the language development scale at 2 years than GF infants (88.5 [78.5; 96.5] vs. 84.5 [69.5; 91.5], p = 0.03). The Bayley-III test was available for 35 infants. We found a significant difference in motor development, with a higher score in the NGF group (94 [88; 100] vs. 85 [79; 91], p = 0.03).
Conclusions:
In this cohort study, GF is associated with growth differences till 2 years CA, and with lower scores in neurodevelopment assessment.
