Head growth in sick premature infants--a longitudinal study

Area of Science:

• Neonatalogy
• Pediatric Growth and Development
• Neurodevelopmental Pediatrics

Background:

• Preterm infants with severe neonatal problems exhibit significant growth challenges.
• Understanding brain growth dynamics in sick neonates is crucial for long-term outcomes.
• Distinguishing normal growth patterns from pathological conditions like hydrocephalus is vital.

Purpose of the Study:

• To assess somatic and head circumference growth velocity in sick preterm infants.
• To investigate the relationship between head growth patterns and potential hydrocephalus.
• To determine the impact of acute illness and recovery on infant growth trajectories.

Main Methods:

• Serial weekly measurements of somatic growth and head circumference over ten weeks.
• Study cohort: 41 preterm infants (gestational age 28-32 weeks) with severe neonatal issues.
• Comparison group: Six similar infants with head circumference following intrauterine growth curve.

Main Results:

• Sick infants showed sub-optimal growth velocity, deviating below the normal fetal growth curve during acute illness.
• Head growth normalized and exhibited catch-up growth during the recovery phase.
• Infants whose head circumference tracked the intrauterine curve developed hydrocephalus.

Conclusions:

• Brain growth is impaired in sick preterm infants; normal head growth may signal hydrocephalus.
• Significant 'catch-up' head growth occurs post-recovery, indicating brain plasticity.
• Normal growth in sick, low-birth-weight infants is contingent upon resolution of acute illness, despite adequate energy intake.