In Preterm Infants, Length Growth below Expected Growth during Hospital Stay Predicts Poor Neurodevelopment at 2 Years.
Neonatology
; 114(2): 135-141, 2018.
Article
em En
| MEDLINE
| ID: mdl-29847833
ABSTRACT
BACKGROUND:
In preterm infants, neonatal weight growth is associated with neurodevelopmental outcome but is a poor indicator of growth quality.OBJECTIVE:
The aim of this work was to measure the relationship between neonatal length growth and the 2-year neurological outcome in preterm infants.METHODS:
A total of 2,403 infants enrolled in the LIFT cohort with gestational age less than 34â weeks were studied. Neonatal observed length growth (OLG) was calculated as the change in length Z-score between birth and discharge. Expected length growth (ELG) was estimated based on gestational age, birth weight Z-score, birth length Z-score, gender, and observed neonatal weight growth. The difference between OLG and ELG (∆OLG-ELG) was calculated as OLG - ELG, and infants were ranked into 3 classes depending on their ∆OLG-ELG (≤-0.5, -0.49 to 0.49, ≥0.50 Z-score). We explored the relationship between ∆OLG-ELG and 2-year neurodevelopmental outcome (n = 2,036), and, in a subgroup (n = 85), between ∆OLG-ELG and body composition at discharge.RESULTS:
ELG was strongly predicted from the above-mentioned parameters (R2 = 0.73, p = 0.001). OLG correlated closely with gestational age (p = 0.001) but ∆OLG-ELG did not (p = 1.0). OLG was not associated with a 2-year nonoptimal outcome after adjustment for gestational age, but ∆OLG-ELG ≤-0.5 was; the crude and adjusted odds ratios were 1.63 and 1.56, respectively. ∆OLG-ELG correlated negatively with fat mass (R2 = 0.29, p = 0.006) before and after adjustment for gestational age.CONCLUSION:
∆OLG-ELG is a marker of neonatal growth that does not depend on gestational age, and may reflect quality of growth. A ∆OLG-ELG ≤-0.5 Z-score is associated with a higher risk for 2-year nonoptimal neurodevelopmental outcome.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Recém-Nascido Prematuro
/
Desenvolvimento Infantil
/
Deficiências do Desenvolvimento
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
Limite:
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
/
Newborn
País/Região como assunto:
Europa
Idioma:
En
Revista:
Neonatology
Assunto da revista:
PERINATOLOGIA
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
França
País de publicação:
CH
/
SUIZA
/
SUÍÇA
/
SWITZERLAND