Weight Growth Velocity and Neurodevelopmental Outcomes in Extremely Low Birth Weight Infants

Abstract

IntroductionThis study aimed to assess whether weight growth velocity (WGV) predicts neurodevelopmental outcomes in extremely low birth weight infants (ELBWIs).MethodsSubjects were infants who weighed 501–1000 g at birth and were included in the cohort of the Neonatal Research Network of Japan (2003–2007). Patel’s exponential model (EM) method was used to calculate WGV between birth and discharge. Assessment of predictions of death or neurodevelopmental impairment (NDI) was performed at 3 years of age based on the WGV score, which was categorized by per one increase in WGV. Multivariate logistic regression analysis was used to calculate adjusted odds ratios and their 95% confidence intervals (95%CI).ResultsIn the 2961 ELBWIs assessed, the median WGV was 10.5 g/kg/day (interquartile, 9.4–11.9). With the categorical approach, the adjusted odds ratios for death or NDI with WGV scores of 6 and 7 were 2.41 (95%CI, 1.60–3.62) and 1.81 (95%CI, 1.18–2.75), respectively, relative to the reference WGV score of 10. WGV scores ≥8 did not predict death or NDI.ConclusionsWGV scores <8 were significant predictors suggesting that values of WGV during hospitalization in a NICU are associated with neurodevelopmental outcomes. Further investigations is necessary to determine whether additional nutritional support may improve low WGV in ELBWIs.

Post-discharge body weight and neurodevelopmental outcomes among very low birth weight infants in Taiwan: A nationwide cohort study

“…[ 31 , 50 – 56 ] Poor growth velocity during hospitalization (EUGR) was also related to poor psychomotor outcome in early childhood. [ 25 , 34 , 43 , 57 , 58 ] Thus, early and aggressive nutritional support for adequate body weight gain during hospitalization in VLBW infants, which may mitigate the risks of neurodevelopmental disorders, appears to be the current consensus of opinion in the literature. [ 25 , 43 , 57 – 59 ] In our study, after adjusting for SGA and EUGR, failure to thrive after discharge was still an independent factor for poor neurodevelopmental outcomes in the VLBW infants.…”

Neurodevelopment at 3 Years in Neonates Born by Vaginal Delivery versus Cesarean Section at <26 Weeks of Gestation: Retrospective Analysis of a Nationwide Registry in Japan

“…Moreover, the number of certified psychologists who evaluated the KSPD was limited, even at levels 2-3 NICUs in Japan. All of these issues are related to a high rate of missing follow-up data, which was commonly observed in previous research using NRNJ registry data [2,24] . We assumed that the reasons for missing data were not related to events or outcomes (i.e., mode of delivery or neurodevelopment), and we analyzed data of patients with a complete set of data (i.e., complete case analysis).…”

Standardized Nutrition Protocol for Very Low‐Birth‐Weight Infants Resulted in Less Use of Parenteral Nutrition and Associated Complications, Better Growth, and Lower Rates of Necrotizing Enterocolitis

“…This could be related to difficulty in optimizing energy in PN due to glucose and lipid intolerance, poor caloric and protein delivery that occurs while feeds are being advanced and PN is weaned, as well as increased metabolic demands . Infants with EUGR are at risk for poorer neurodevelopmental outcomes, worsened neonatal intensive care unit (NICU) outcomes, and adult‐onset disease …”

“…5,10,11 Infants with EUGR are at risk for poorer neurodevelopmental outcomes, worsened neonatal intensive care unit (NICU) outcomes, and adult-onset disease. [12][13][14][15][16] Studies have shown that the use of preterm feeding protocols in the NICU can improve feeding tolerance and decrease the risk for NEC. [17][18][19] They have also shown reduced PN use and days to full feeds, reduced late-onset sepsis, fewer line days, and improved growth.…”