Intrauterine, Early Neonatal, and Postdischarge Growth and Neurodevelopmental Outcome at 5.4 Years in Extremely Preterm Infants After Intensive Neonatal Nutritional Support

Franz, Axel R.; Pohlandt, Frank; Bode, Harald; Mihatsch, Walter; Sander, Silvia; Kron, Martina; Steinmacher, Jochen

doi:10.1542/peds.2008-1352

Cited by 402 publications

(356 citation statements)

References 41 publications

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“…7 Treatments such as mechanical ventilation may adversely affect cognitive development, 8 while nutritional support may help improve neurodevelopmental outcomes. 9 In contrast, a favorable early social environment including responsive parenting may stimulate cognitive development 10 and VP/VLBW infants are more affected by both favorable and unfavorable environments than term-born infants. 11 Unknown is which prenatal, perinatal, and neonatal factors most strongly predict adult cognitive abilities, thus the goal of this study was to investigate the combined and separate risks of pregnancy complications, neonatal morbidity, neonatal treatment, and early social environment on adult cognitive abilities in a large prospective sample of VP/VLBW individuals.…”

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confidence: 99%

Neonatal predictors of cognitive ability in adults born very preterm: a prospective cohort study

Breeman

Jaekel

Baumann

et al. 2017

Develop Med Child Neuro

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Aim To identify neonatal predictors to allow a developmental prognosis of the cognitive abilities of survivors born very preterm/very low birthweight (VLBW) into adult life. Method The Bavarian Longitudinal Study is a prospective whole‐population study that followed 260 infants born very preterm/VLBW from birth to adulthood. Regression analyses examined which neonatal factors predicted adult IQ. Results Neonatal morbidity, neonatal treatment, and early social environment of infants born very preterm/VLBW explained 37.6% of the variance in adult IQ. Seven unique early‐life predictors of lower adulthood IQ were found: respiratory distress syndrome, intraventricular haemorrhage, problems with mobility, mechanical ventilation, less parenteral nutrition, low/middle socioeconomic status, and poor early parent–infant relationships. Specifically, modifiable factors such as mechanical ventilation predicted a drop of 0.43 IQ points for each day of treatment, adjusted for initial respiratory problems. Good early parent–infant relationships predicted an approximately 5‐point increase in adult IQ, adjusted for other significant predictors such as socioeconomic status. Interpretation Mechanical ventilation, parenteral feeding, and early parenting were identified as significant modifiable factors that were strongly related to adult IQ. Mechanical ventilation policies have changed but there is scope for early interventions that focus on positive parenting, which may reduce the adverse effects of very preterm/VLBW birth on cognitive abilities.

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Neonatal predictors of cognitive ability in adults born very preterm: a prospective cohort study

Breeman

Jaekel

Baumann

et al. 2017

Develop Med Child Neuro

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“…23 When schoolchildren who had been very low birth weight preterms were assessed, it was observed that inadequate intrauterine growth had an effect on cognitive development, but not on motor development. 24 This variation between study results is probably because of differences in patient samples, methods and follow-up duration, but, in general, the data warn that small for gestational age premature infants have poor developmental prognosis, having been exposed to a situation of double risk: a reduced gestation period and intrauterine growth restriction.…”

Section: Resultsmentioning

confidence: 99%

Aquisição de habilidades motoras até a marcha independente em prematuros de muito baixo peso

Volpi¹,

Rugolo²,

Peraçoli³

et al. 2010

J. Pediatr. (Rio J.)

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Objective: To determine chronological and corrected ages at acquisition of motor abilities up to independent walking in very low birth weight preterms and to determine up to what point it is necessary to use corrected age. Methods:This was a longitudinal study of preterms with birth weight < 1,500 g and gestational age ≤ 34 weeks, free from neurosensory sequelae, selected at the high-risk infants follow-up clinic at the Hospital das Clínicas, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP) in Botucatu, Brazil, between 1998 to 2003, and assessed every 2 months until acquisition of independent walking.Results: Nine percent of the 155 preterms recruited were excluded from the study, leaving a total of 143 patients. The mean gestational age was 30±2 weeks, birth weight was 1,130±222 g, 59% were female and 44% were small for gestational age. Preterms achieved head control in their second month, could sit independent at 7 months and walked at 12.8 months' corrected age, corresponding to the 4th, 9th and 15th months of chronological age. There were significant differences between chronological age and corrected age for all motor abilities. Preterms who were small for their gestational age acquired motor abilities later, but still within expected limits. Conclusions:Very low birth weight preterms, free from neurosensory disorders, acquired their motor abilities within the ranges expected for their corrected ages. Corrected age should be used until independent walking is achieved. J Pediatr (Rio J). 2010;86(2):143-148:Very low birth weight newborn, motor activity, development, gestational age.

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“…In clinical studies, brain and cranial growth have been associated with subsequent neurodevelopment (5,39). A polymorphism in the IGF I promotor gene, which is known to regulate serum IGF I levels, has been related with slower cranial growth from birth until 5 y of age (40).…”

Section: The Role Of Igf I In Neurodevelopmentmentioning

confidence: 99%

“…Preterm birth and postnatal growth restriction have both been associated with impaired neurodevelopmental outcome (4). However, Franz et al found that only a small percentage of the variability, roughly 3%, of the mental processing composite score was explained by growth (5). There might be a common factor leading to both poor growth and poor neurodevelopment, e.g., a poor nutritional status or major neonatal morbidities.…”

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Dietary proteins and IGF I levels in preterm infants: determinants of growth, body composition, and neurodevelopment

2014

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Intrauterine, Early Neonatal, and Postdischarge Growth and Neurodevelopmental Outcome at 5.4 Years in Extremely Preterm Infants After Intensive Neonatal Nutritional Support

Cited by 402 publications

References 41 publications

Neonatal predictors of cognitive ability in adults born very preterm: a prospective cohort study

Neonatal predictors of cognitive ability in adults born very preterm: a prospective cohort study

Aquisição de habilidades motoras até a marcha independente em prematuros de muito baixo peso

Dietary proteins and IGF I levels in preterm infants: determinants of growth, body composition, and neurodevelopment

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