Contemporary Definitions of Infant Growth Failure and Neurodevelopmental and Behavioral Outcomes in Extremely Premature Infants at Two Years of Age

Abstract

Introduction: The association of 2-year neurodevelopmental and behavioral outcomes with in-hospital or post-discharge growth failure (GF) using contemporary definitions for preterm infants is unknown. Methods In a secondary analysis of a preterm cohort, changes in anthropometric z-scores were examined between birth and hospital discharge, and from discharge to 2 years. The 2-year evaluation included Bayley Scales of Infant Development (BSID-III) and Child Behavior Checklist (CBCL). Results Among 629 infants, accelerated linear growth from birth to discharge was associated with higher BSID-III cognitive scores (+ 3.2 points [IQR 0.02, 6.4]) while in-hospital GF was not associated with any outcomes. Infants with weight GF after discharge had lower BSID-III motor scores (-3.1 points [-5.9, -0.2]). Infants with accelerated weight growth after discharge had increased odds of behavioral problems on the CBCL (aOR 1.9 [1.03, 3.5]). Discussion In-hospital and post-hospitalization growth metrics are modestly associated with neurodevelopmental outcomes with length gains apparently most beneficial.

Growth of Extremely Low Birth Weight Infants (ELBW) born at a Tertiary Hospital: Statural catch-up growth continues during the 3rd year of life

“…(6)(7)(8)(9) Additionally, investigations have revealed the relationship between postnatal growth and long-term neurodevelopmental outcomes in ELBW infants, emphasizing the lasting consequences of growth challenges. (10)(11)(12)(13)(14) Variable degrees of catch-up were reported by different authors at different times postnatally. For instance, Raaijmakers et al conducted a comprehensive study that examined the postnatal growth patterns of ELBW infants for 11 years and identified that Catch-up growth (i.e., ΔZ-score >0.67 SDS) for weight was achieved during the first two years of life in only 9.9% of cases, for length in 13.7% of cases and for head circumference in 14.1% of cases.…”