Influence of Perinatal Nutrition and Gestational Age on Neurodevelopment of Very Low-Birth-Weight Preterm Infants

Filipouski, Gabriela Ribeiro; Silveira, Rita C.; Procianoy, Renato S.

doi:10.1055/s-0032-1331030

Cited by 6 publications

(5 citation statements)

References 22 publications

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“…Growth and development were also studied in a Brazilian collective of very low birthweight (birthweight < 1500 g) infants. Similar to our results, this study showed that growth was not a significant predictor for neurodevelopment [29].…”

Section: Discussionsupporting

confidence: 91%

Association of growth with neurodevelopment in extremely low gestational age infants: a population-based analysis

Gerull

Huber²,

Rousson³

et al. 2022

Eur J Pediatr

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To assess the association between postnatal growth and neurodevelopment at the age of 2 years in extremely low gestational age newborns (ELGAN, < 28 weeks’ gestation). Retrospective population-based cohort study including all live born ELGAN in 2006–2012 in Switzerland. Growth parameters (weight, length, head circumference, body mass index) were assessed at birth, at hospital discharge home, and 2-year follow-up (FU2). Unadjusted and adjusted regression models assessed associations between growth (birth to hospital discharge and birth to FU2) and neurodevelopment at FU2. A total of 1244 infants (mean GA 26.5 ± 1.0 weeks, birth weight 853 ± 189 g) survived to hospital discharge and were included in the analyses. FU2 was documented for 1049 (84.3%) infants. The mean (± SD) mental and a psychomotor development index at 2FU were 88.9 (± 18.0) and 86.9 (± 17.7), respectively. Moderate or severe neurodevelopmental impairment was documented in 23.2% of patients. Changes of z-scores between birth and discharge and between birth and FU2 for weight were − 1.06 (± 0.85) and − 0.140 (± 1.15), for length − 1.36 (± 1.34), and − 0.40 (± 1.33), for head circumference − 0.61 (± 1.04) and − 0.76 (± 1.32) as well as for BMI 0.22 (± 3.36) and − 0.006 (± 1.45). Unadjusted and adjusted analyses showed that none of the four growth parameters was significantly associated with any of the three outcome parameters of neurodevelopment. This was consistent for both time intervals.Conclusion: In the present population-based cohort of ELGAN, neither growth between birth and hospital discharge nor between birth and FU2 were significantly associated with neurodevelopment at age of 2 years. What is Known:• Studies assessing the association between growth and neurodevelopment in extremely low gestational age newborns (28 weeks’ gestation) show conflicting results. What is New:• Neither growth between birth and hospital discharge nor between birth and corrected age of 2 years were significantly associated with neurodevelopment at age of 2 years.• The role of postnatal growth as a predictor of neurodevelopmental outcome during infancy might be smaller than previously assumed.

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Section: Discussionsupporting

confidence: 91%

Association of growth with neurodevelopment in extremely low gestational age infants: a population-based analysis

Gerull

Huber²,

Rousson³

et al. 2022

Eur J Pediatr

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“…In total, 89 samples from 60 studies including 52 822 children compared preterm and term-born children who had IUGR and were SGA with children with AGA with respect to cognitive outcomes. A total of 48 studies reported results for mean cognitive scores, and 24 studies reported the percentages of group-specific children with BII …”

Section: Resultsmentioning

confidence: 99%

Association of Intrauterine Growth Restriction and Small for Gestational Age Status With Childhood Cognitive Outcomes

et al. 2020

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The magnitude of the association of intrauterine growth restriction (IUGR) and small for gestational age (SGA) status with cognitive outcomes in preterm and term-born children has not been established.OBJECTIVE To examine cognitive outcomes of preterm and term-born children who had IUGR and were SGA compared with children who were appropriate for gestational age (AGA) during the first 12 years of life.DATA SOURCES For this systematic review and meta-analysis, the Scopus, PubMed, Web of Science, Science Direct, PsycInfo, and ERIC databases were searched for English-language, peer-reviewed literature published between January 1, 2000, and February 20, 2020. The following Medical Subject Heading terms for IUGR and SGA and cognitive outcomes were used: intrauterine growth restriction, intrauterine growth retardation, small for gestational age AND neurodevelopment, neurodevelopmental outcome, developmental outcomes, and cognitive development.STUDY SELECTION Inclusion criteria were assessment of cognitive outcomes (full-scale IQ or a cognitive subscale), inclusion of an AGA group as comparison group, and inclusion of gestational age at birth and completion of cognitive assessment up to 12 years of age. DATA EXTRACTION AND SYNTHESISThe Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guidelines were followed. Data were double screened for full-text articles, and a subset were independently coded by 2 authors. Standardized mean differences (SMDs) and odd ratios from individual studies were pooled by applying random-effects models. MAIN OUTCOMES AND MEASURESCognitive outcomes, defined as mental, cognitive, or IQ scores, estimated with standardized practitioner-based cognitive tests or as borderline intellectual impairment (BII), defined as mental, cognitive, or IQ scores at least 1 SD below the mean cognitive score. RESULTSIn this study of 89 samples from 60 studies including 52 822 children, children who had IUGR and were SGA had significantly poorer cognitive outcomes (eg, cognitive scores and BII) than children with AGA in childhood. For cognitive scores, associations are consistent for preterm (SMD, −0.27; 95% CI, −0.38 to −0.17) and term-born children (SMD, −0.39; 95% CI, −0.50 to −0.28), with higher effect sizes reported for term-born IUGR and AGA group comparisons (SMD, -0.58; 95% CI, -0.82 to -0.35). Analyses on BII revealed a significantly increased risk in the preterm children who had IUGR and were SGA (odds ratio, 1.57; 95% CI, 1.40-1.77) compared with the children with AGA.CONCLUSIONS AND RELEVANCE Growth vulnerabilities assessed antenatally (IUGR) and at the time of birth (SGA) are significantly associated with lower childhood cognitive outcomes in preterm and term-born children compared with children with AGA. These findings highlight the need to develop interventions that boost cognitive functions in these high-risk groups.

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“…Filipouski in Brazil and Zoban in the Czech Republic show similar results. [26,27] Our study did not fi nd direct relationship between birth weight and normal neurodevelopment expected according to the international literature, including research by Stoinska, which found lower birth weight associated with higher incidence of abnormalities, [28] and Kwinta's study, which associated birth weight of <1000 g with more severe neurodevelopmental disorders. [29] It is worth noting that the latter was a followup study up to age seven years, while ours was up to age two years.…”

Section: Original Researchmentioning

confidence: 50%

Neurodevelopment of Very Low Birth Weight Infants in the First Two Years of Life in a Havana Tertiary Care Hospital

2015

MEDICC Review

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Influence of Perinatal Nutrition and Gestational Age on Neurodevelopment of Very Low-Birth-Weight Preterm Infants

Abstract: Immaturity is the most important variable associated with better neurodevelopment outcome in very preterm infants.

Cited by 6 publications

References 22 publications

Association of growth with neurodevelopment in extremely low gestational age infants: a population-based analysis

Association of growth with neurodevelopment in extremely low gestational age infants: a population-based analysis

Association of Intrauterine Growth Restriction and Small for Gestational Age Status With Childhood Cognitive Outcomes

Neurodevelopment of Very Low Birth Weight Infants in the First Two Years of Life in a Havana Tertiary Care Hospital

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