Karen Lidzba1, Susanne Rodemann2, Rangmar Goelz3, Ingeborg Krägeloh-Mann4, Andrea Bevot5. 1. University Children's Hospital Tübingen, Department of Pediatric Neurology and Developmental Medicine, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany. Electronic address: karen.lidzba@med.uni-tuebingen.de. 2. University Children's Hospital Tübingen, Department of Pediatric Neurology and Developmental Medicine, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany. Electronic address: susanne.rodemann@freenet.de. 3. University Children's Hospital Tübingen, Department of Neonatology, Calwerstr. 7, 72076 Tübingen, Germany. Electronic address: rangmar.goelz@med.uni-tuebingen.de. 4. University Children's Hospital Tübingen, Department of Pediatric Neurology and Developmental Medicine, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany. Electronic address: ingeborg.kraegeloh-mann@med.uni-tuebingen.de. 5. University Children's Hospital Tübingen, Department of Pediatric Neurology and Developmental Medicine, Hoppe-Seyler-Str. 1, 72076 Tübingen, Germany. Electronic address: andrea.bevot@med.uni-tuebingen.de.
Abstract
BACKGROUND: The contribution of growth parameters to the cognitive outcome of very low birth weight (VLBW)/very preterm (VP) infants is difficult to disentangle from other preterm-birth related factors. AIMS: We hypothesized that long-term cognitive and motor outcome of VLBW/VP infants is most strongly associated with growth in head circumference after hospital discharge. STUDY DESIGN: Single-centre prospective longitudinal study: anthropometric measures at different time points (birth, discharge, school-age). SUBJECTS: 136 VLBW/VP infants (<32weeks gestation/birth weight<1.500g). OUTCOME MEASURES: Cognitive and motor function (Kaufman Assessment Battery for Children; Movement Assessment Battery for Children) at school-age (6.7-10.0years, mean=8.2). RESULTS: In hierarchical multiple regression analyses, growth from birth to discharge significantly predicted cognitive outcome (weight: R2change=0.063, p=0.014; length: R2change=0.078, p=0.007; HC: R2change=0.050, p=0.030), as well as weight gain (R2change=0.096, p=0.001) and head growth (R2change=0.134, p<0.001) from discharge to school-age. While most growth parameters, especially those from birth to discharge, were significantly influenced by prenatal growth and immaturity related morbidity (R2=0.151 to 0.605, all p≤0.001), head growth after discharge was not (R2=0.029, p=0.461). CONCLUSIONS: Amongst all anthropometric measures, head growth between discharge and school-age is the best independent predictor for cognitive outcome in VLBW/VP infants. Determinants of head growth after discharge need further studies to identify targets for intervention.
BACKGROUND: The contribution of growth parameters to the cognitive outcome of very low birth weight (VLBW)/very preterm (VP) infants is difficult to disentangle from other preterm-birth related factors. AIMS: We hypothesized that long-term cognitive and motor outcome of VLBW/VP infants is most strongly associated with growth in head circumference after hospital discharge. STUDY DESIGN: Single-centre prospective longitudinal study: anthropometric measures at different time points (birth, discharge, school-age). SUBJECTS: 136 VLBW/VP infants (<32weeks gestation/birth weight<1.500g). OUTCOME MEASURES: Cognitive and motor function (Kaufman Assessment Battery for Children; Movement Assessment Battery for Children) at school-age (6.7-10.0years, mean=8.2). RESULTS: In hierarchical multiple regression analyses, growth from birth to discharge significantly predicted cognitive outcome (weight: R2change=0.063, p=0.014; length: R2change=0.078, p=0.007; HC: R2change=0.050, p=0.030), as well as weight gain (R2change=0.096, p=0.001) and head growth (R2change=0.134, p<0.001) from discharge to school-age. While most growth parameters, especially those from birth to discharge, were significantly influenced by prenatal growth and immaturity related morbidity (R2=0.151 to 0.605, all p≤0.001), head growth after discharge was not (R2=0.029, p=0.461). CONCLUSIONS: Amongst all anthropometric measures, head growth between discharge and school-age is the best independent predictor for cognitive outcome in VLBW/VP infants. Determinants of head growth after discharge need further studies to identify targets for intervention.
Authors: Pilar Medina-Alva; Kevin R Duque; Alonso Zea-Vera; Sicilia Bellomo; César Cárcamo; Daniel Guillen-Pinto; Maria Rivas; Alfredo Tori; Jaime Zegarra; Luis Cam; Anne Castañeda; Aasith Villavicencio; Theresa J Ochoa Journal: Early Hum Dev Date: 2019-02-08 Impact factor: 2.079