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Association of Postnatal Growth Changes and Neurodevelopmental Outcomes in Preterm Neonates of <29 Weeks’ Gestation
To examine associations between weight and head circumference (HC) changes and neurodevelopment in preterm infants. This retrospective cohort study of Canadian Neonatal Network and Canadian Neonatal Follow-Up Network sites included preterm infants born 2010-2018. Logistic regression and model diagno...
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| Published in: | The Journal of pediatrics 2023-05, Vol.256, p.63-69.e2 |
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| Main Authors: | , , , , , , , |
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| Language: | English |
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| cites | cdi_FETCH-LOGICAL-c359t-5c76b0542e52c40b7a029b2076fc49427467ed15994075be7c5b406494a462b3 |
| container_end_page | 69.e2 |
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| container_start_page | 63 |
| container_title | The Journal of pediatrics |
| container_volume | 256 |
| creator | Bando, Nicole Fenton, Tanis R. Yang, Junmin Ly, Linh Luu, Thuy Mai Unger, Sharon O'Connor, Deborah L. Shah, Prakesh S. |
| description | To examine associations between weight and head circumference (HC) changes and neurodevelopment in preterm infants.
This retrospective cohort study of Canadian Neonatal Network and Canadian Neonatal Follow-Up Network sites included preterm infants born 2010-2018. Logistic regression and model diagnostics evaluated relationships between changes in z score and velocity of weight and HC from birth to discharge from a tertiary neonatal intensive care unit, discharge to 18-24 months corrected age (CA), and birth to 18-24 months CA and significant cognitive/motor impairment at 18-24 months CA classified using a Bayley Scales of Infant and Toddler Development-Third Edition cognitive or motor composite score |
| doi_str_mv | 10.1016/j.jpeds.2022.11.039 |
| format | article |
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This retrospective cohort study of Canadian Neonatal Network and Canadian Neonatal Follow-Up Network sites included preterm infants born 2010-2018. Logistic regression and model diagnostics evaluated relationships between changes in z score and velocity of weight and HC from birth to discharge from a tertiary neonatal intensive care unit, discharge to 18-24 months corrected age (CA), and birth to 18-24 months CA and significant cognitive/motor impairment at 18-24 months CA classified using a Bayley Scales of Infant and Toddler Development-Third Edition cognitive or motor composite score <70.
In total, 4530 infants (53.0% male) with a mean (SD) gestational age of 26.3 (1.4) weeks and birth weight of 920 (227) g were included. Weight and HC changes were associated with lower odds of significant cognitive/motor impairment including an OR of 0.87 (95% CI: 0.83, 0.91; P < .001) for a 1-g/d increase in weight from discharge to 18-24 months CA and 0.81 (95% CI: 0.75, 0.88; P < .001) for a 1-unit increase in HC z score from birth to 18-24 months CA. Associations were not statistically significant in morbidity-free neonates. Weight and HC gains poorly discriminated between infants with and without significant cognitive/motor impairment (areas under the receiver operating characteristic curve of <0.64). No growth measure had a clinically useful balance of sensitivity and specificity.
Weight and HC changes were associated with significant cognitive/motor impairment but had poor discriminatory capability. Neonatal morbidities may make a larger contribution than postnatal growth to neurodevelopment.</description><identifier>ISSN: 0022-3476</identifier><identifier>EISSN: 1097-6833</identifier><identifier>DOI: 10.1016/j.jpeds.2022.11.039</identifier><identifier>PMID: 36509160</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Canada - epidemiology ; Child Development ; discharge ; Female ; Gestational Age ; head circumference ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Male ; neurodevelopment ; Pregnancy ; preterm infant ; Retrospective Studies ; weight</subject><ispartof>The Journal of pediatrics, 2023-05, Vol.256, p.63-69.e2</ispartof><rights>2022 Elsevier Inc.</rights><rights>Copyright © 2022 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-5c76b0542e52c40b7a029b2076fc49427467ed15994075be7c5b406494a462b3</citedby><cites>FETCH-LOGICAL-c359t-5c76b0542e52c40b7a029b2076fc49427467ed15994075be7c5b406494a462b3</cites><orcidid>0000-0002-9920-0488</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36509160$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bando, Nicole</creatorcontrib><creatorcontrib>Fenton, Tanis R.</creatorcontrib><creatorcontrib>Yang, Junmin</creatorcontrib><creatorcontrib>Ly, Linh</creatorcontrib><creatorcontrib>Luu, Thuy Mai</creatorcontrib><creatorcontrib>Unger, Sharon</creatorcontrib><creatorcontrib>O'Connor, Deborah L.</creatorcontrib><creatorcontrib>Shah, Prakesh S.</creatorcontrib><creatorcontrib>Canadian Neonatal Network and Canadian Neonatal Follow-Up Network Investigators</creatorcontrib><title>Association of Postnatal Growth Changes and Neurodevelopmental Outcomes in Preterm Neonates of <29 Weeks’ Gestation</title><title>The Journal of pediatrics</title><addtitle>J Pediatr</addtitle><description>To examine associations between weight and head circumference (HC) changes and neurodevelopment in preterm infants.
This retrospective cohort study of Canadian Neonatal Network and Canadian Neonatal Follow-Up Network sites included preterm infants born 2010-2018. Logistic regression and model diagnostics evaluated relationships between changes in z score and velocity of weight and HC from birth to discharge from a tertiary neonatal intensive care unit, discharge to 18-24 months corrected age (CA), and birth to 18-24 months CA and significant cognitive/motor impairment at 18-24 months CA classified using a Bayley Scales of Infant and Toddler Development-Third Edition cognitive or motor composite score <70.
In total, 4530 infants (53.0% male) with a mean (SD) gestational age of 26.3 (1.4) weeks and birth weight of 920 (227) g were included. Weight and HC changes were associated with lower odds of significant cognitive/motor impairment including an OR of 0.87 (95% CI: 0.83, 0.91; P < .001) for a 1-g/d increase in weight from discharge to 18-24 months CA and 0.81 (95% CI: 0.75, 0.88; P < .001) for a 1-unit increase in HC z score from birth to 18-24 months CA. Associations were not statistically significant in morbidity-free neonates. Weight and HC gains poorly discriminated between infants with and without significant cognitive/motor impairment (areas under the receiver operating characteristic curve of <0.64). No growth measure had a clinically useful balance of sensitivity and specificity.
Weight and HC changes were associated with significant cognitive/motor impairment but had poor discriminatory capability. Neonatal morbidities may make a larger contribution than postnatal growth to neurodevelopment.</description><subject>Canada - epidemiology</subject><subject>Child Development</subject><subject>discharge</subject><subject>Female</subject><subject>Gestational Age</subject><subject>head circumference</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Male</subject><subject>neurodevelopment</subject><subject>Pregnancy</subject><subject>preterm infant</subject><subject>Retrospective Studies</subject><subject>weight</subject><issn>0022-3476</issn><issn>1097-6833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kE1uFDEQhS0EIkPgBEiol2y6Kf_HEiyiEZkgRSSLSCwtt7uGeOhuD3b3ROxyDXachaPkJHgygSWrkup99Z7qEfKaQkOBqnebZrPFLjcMGGsobYCbJ2RBwehanXD-lCygKDUXWh2RFzlvAMAIgOfkiCsJhipYkN1pztEHN4U4VnFdXcU8jW5yfbVK8Xa6qZY3bvyKuXJjV33GOcUOd9jH7YDjnrqcJx-Hooexuko4YRoKFotF2RW_98z8_vUF8Vu-v_tZrTBPD1EvybO16zO-epzH5Prs4_XyvL64XH1anl7Unksz1dJr1YIUDCXzAlrtgJmWgVZrL4xgWiiNHZWm_KVli9rLVoAqkhOKtfyYvD3YblP8PpdwO4Tsse_diHHOlmkpQGjJTwrKD6hPMeeEa7tNYXDph6Vg933bjX3o2-77tpTa0ne5evMYMLcDdv9u_hZcgA8HAMuXu4DJZh9w9NiFhH6yXQz_DfgDo-iT5g</recordid><startdate>202305</startdate><enddate>202305</enddate><creator>Bando, Nicole</creator><creator>Fenton, Tanis R.</creator><creator>Yang, Junmin</creator><creator>Ly, Linh</creator><creator>Luu, Thuy Mai</creator><creator>Unger, Sharon</creator><creator>O'Connor, Deborah L.</creator><creator>Shah, Prakesh S.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9920-0488</orcidid></search><sort><creationdate>202305</creationdate><title>Association of Postnatal Growth Changes and Neurodevelopmental Outcomes in Preterm Neonates of <29 Weeks’ Gestation</title><author>Bando, Nicole ; Fenton, Tanis R. ; Yang, Junmin ; Ly, Linh ; Luu, Thuy Mai ; Unger, Sharon ; O'Connor, Deborah L. ; Shah, Prakesh S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-5c76b0542e52c40b7a029b2076fc49427467ed15994075be7c5b406494a462b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Canada - epidemiology</topic><topic>Child Development</topic><topic>discharge</topic><topic>Female</topic><topic>Gestational Age</topic><topic>head circumference</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Male</topic><topic>neurodevelopment</topic><topic>Pregnancy</topic><topic>preterm infant</topic><topic>Retrospective Studies</topic><topic>weight</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bando, Nicole</creatorcontrib><creatorcontrib>Fenton, Tanis R.</creatorcontrib><creatorcontrib>Yang, Junmin</creatorcontrib><creatorcontrib>Ly, Linh</creatorcontrib><creatorcontrib>Luu, Thuy Mai</creatorcontrib><creatorcontrib>Unger, Sharon</creatorcontrib><creatorcontrib>O'Connor, Deborah L.</creatorcontrib><creatorcontrib>Shah, Prakesh S.</creatorcontrib><creatorcontrib>Canadian Neonatal Network and Canadian Neonatal Follow-Up Network Investigators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bando, Nicole</au><au>Fenton, Tanis R.</au><au>Yang, Junmin</au><au>Ly, Linh</au><au>Luu, Thuy Mai</au><au>Unger, Sharon</au><au>O'Connor, Deborah L.</au><au>Shah, Prakesh S.</au><aucorp>Canadian Neonatal Network and Canadian Neonatal Follow-Up Network Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of Postnatal Growth Changes and Neurodevelopmental Outcomes in Preterm Neonates of <29 Weeks’ Gestation</atitle><jtitle>The Journal of pediatrics</jtitle><addtitle>J Pediatr</addtitle><date>2023-05</date><risdate>2023</risdate><volume>256</volume><spage>63</spage><epage>69.e2</epage><pages>63-69.e2</pages><issn>0022-3476</issn><eissn>1097-6833</eissn><abstract>To examine associations between weight and head circumference (HC) changes and neurodevelopment in preterm infants.
This retrospective cohort study of Canadian Neonatal Network and Canadian Neonatal Follow-Up Network sites included preterm infants born 2010-2018. Logistic regression and model diagnostics evaluated relationships between changes in z score and velocity of weight and HC from birth to discharge from a tertiary neonatal intensive care unit, discharge to 18-24 months corrected age (CA), and birth to 18-24 months CA and significant cognitive/motor impairment at 18-24 months CA classified using a Bayley Scales of Infant and Toddler Development-Third Edition cognitive or motor composite score <70.
In total, 4530 infants (53.0% male) with a mean (SD) gestational age of 26.3 (1.4) weeks and birth weight of 920 (227) g were included. Weight and HC changes were associated with lower odds of significant cognitive/motor impairment including an OR of 0.87 (95% CI: 0.83, 0.91; P < .001) for a 1-g/d increase in weight from discharge to 18-24 months CA and 0.81 (95% CI: 0.75, 0.88; P < .001) for a 1-unit increase in HC z score from birth to 18-24 months CA. Associations were not statistically significant in morbidity-free neonates. Weight and HC gains poorly discriminated between infants with and without significant cognitive/motor impairment (areas under the receiver operating characteristic curve of <0.64). No growth measure had a clinically useful balance of sensitivity and specificity.
Weight and HC changes were associated with significant cognitive/motor impairment but had poor discriminatory capability. Neonatal morbidities may make a larger contribution than postnatal growth to neurodevelopment.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>36509160</pmid><doi>10.1016/j.jpeds.2022.11.039</doi><orcidid>https://orcid.org/0000-0002-9920-0488</orcidid></addata></record> |
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| ispartof | The Journal of pediatrics, 2023-05, Vol.256, p.63-69.e2 |
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| language | eng |
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| source | Elsevier:Jisc Collections:Elsevier Read and Publish Agreement 2022-2024:Freedom Collection (Reading list) |
| subjects | Canada - epidemiology Child Development discharge Female Gestational Age head circumference Humans Infant Infant, Newborn Infant, Premature Male neurodevelopment Pregnancy preterm infant Retrospective Studies weight |
| title | Association of Postnatal Growth Changes and Neurodevelopmental Outcomes in Preterm Neonates of <29 Weeks’ Gestation |
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