WHAT'S KNOWN ON THIS SUBJECT: Better postnatal growth, especially head growth, associates with better cognitive development in preterm infants. Suboptimal postnatal growth is more common in infants with poor antenatal growth than in infants with normal growth. WHAT THIS STUDY ADDS:Good weight gain and head circumference growth until 2 years was associated with better 5-year cognitive outcome in non-small for gestational age infants. Good head circumference growth around term age benefits the cognitive outcome of small for gestational age infants. abstract OBJECTIVES: To study how antenatal growth affects cognitive outcome in very preterm infants and to determine whether there is an association between growth in any particular time period between birth and 5 years of age and cognitive outcome. Small for gestational age (SGA) and non-SGA infants were analyzed separately, because antenatal growth may affect postnatal growth. and 2006 who were treated at Turku University Hospital (n = 181) were followed. Weight, length, and head circumference (HC) of the infants were measured at 9 time points between birth and 5 years. The growth was determined as a z score change between measurement points. Cognitive development was assessed at 5 years of age with the Wechsler Preschool and Primary Scales of IntelligenceRevised. The association between growth and full-scale IQ (FSIQ) was studied. METHODS:RESULTS: Growth in length and height was not associated with 5-year cognitive outcome. However, weight (r = 0.18, P = .04) and HC growth (r = 0.25, P = .01) between birth and 2 years of corrected age correlated to FSIQ in non-SGA children. In SGA children, HC growth (r = 0.33, P = .03) around term age correlated to FSIQ. CONCLUSIONS:Cognitive outcome was similar in SGA and non-SGA very preterm infants. Growth affected cognition positively in both subgroups, but the critical time period was different. Drs Leppänen and Lind made substantial contributions to conception and design, acquired data, analyzed and interpreted data, and wrote and revised the manuscript; Drs Lapinleimu, Lehtonen, Haataja, and Rautava made substantial contributions to conception and design, analyzed and interpreted data, and wrote and revised the manuscript; Mr Matomäki carried out the statistical analyses, made substantial contributions to conception and design and interpretation of data, and wrote and revised the manuscript; and all authors approved the article to be published. www.pediatrics.org/cgi

Volumetric analysis at brain MRI can provide an additional parameter for early prediction of outcome in VLBW children.

AIM The aim of this study was to assess the cognitive level and neuropsychological performance at 5 years of age in children with a very low birthweight (VLBW; birthweight <1501g) born in 2001 to 2003.METHOD A regional cohort of 97 children with a VLBW (mean gestational age 28wks [SD 3wks]; mean birthweight 1054g [SD 259g]; 50 male; 47 female) and a comparison group of 161 healthy children born at term (mean gestational age 40wks [SD 1wks]; mean birthweight 3644g [SD 446g]; 80 male; 81 female) were included in this study. At 5 years of age (SD 2mo) cognitive level was assessed with the Wechsler Preschool and Primary Scale of Intelligence -revised and neuropsychological performance was assessed using NEPSY II. RESULTSThe mean intelligence of the VLBW group corresponded to the normative mean of 100 but was lower than the mean of the low-risk comparison group (p<0.001). Neuropsychological performance was also significantly poorer than that of the comparison group. In NEPSY II, 25% of the VLBW group had a significantly impaired performance in one of 11 subtests and 33% had a significantly impaired performance in more than one, while 19% of the comparison group had a significantly impaired performance in one subtest and 10% had a significantly impaired performance in more than one.INTERPRETATION The mean cognitive capacity of the VLBW cohort corresponded to the normative mean. However, assessments of cognitive level only at preschool age do not provide the information on neuropsychological deficit that is necessary for planning adequate educational support.Preterm birth predisposes the infant to long-term developmental problems. As diverging developmental outcomes in different regions, 1 centres, 2 hospital levels, 3 and time periods 4,5 have been reported, continuous regional follow-up is needed for the evaluation of treatment and for the planning of adequate developmental support. There are some encouraging reports on the decreasing rate of cerebral palsy (CP) among preterm children, 4,6 as well as on the improved cognitive outcome of preterm children at 2 years of age, 7 but similar trends regarding the neurocognitive outcome at preschool age have not yet been reported. Thus, there is a need to learn more about the long-term cognitive and neuropsychological development of children with a very low birthweight (VLBW) born during the present decade.It has been shown that children who were born preterm achieve lower scores on intelligence tests 8,9 than their peers born at term. They also have more impairments in various domains of neuropsychological functioning than children born at term. [8][9][10][11][12] Some studies suggest that preterm birth is associated with general intellectual impairment rather than with specific dysfunctions, 13 whereas others report specific impairments despite cognitive levels within a normal range. 10 The aim of the present study was to assess cognitive and neuropsychological outcomes at 5 years of age in a regional cohort of children with a VLBW born in 2001 to 2003 and to analyse the e...

Aim: To study the prognostic value of MRI in preterm infants at term equivalent age for cognitive development at 5 years of age.Methods: A total of 217 very low birth weight/very low gestational age infants who all received brain MRI at term equivalent age were categorized into 4 groups based on the brain MRI findings. Cognitive development was assessed at 5 years of chronological age by using a short form of Wechsler Preschool and Primary Scale of IntelligenceRevised. This information was combined with neurosensory diagnoses by 2 years of corrected age.Results: Of all infants 31 (17.0%) had Full Scale Intelligence Quotient (FSIQ) <85, 14 (6.5%) had cerebral palsy and 4 (1.8%) had severe hearing impairment. A total of 41 (22.0%) infants had some neurodevelopmental impairment at 5 years of age. Considering cognitive outcome (FSIQ <85), the positive predictive value of several major MRI pathologies was 43.8%, and the negative predictive value of normal finding or minor pathologies was 92.0% and 85.7%, respectively.