Laure Simon1,2, Camille Théveniaut1, Cyril Flamant1,2, Anne Frondas-Chauty1,2, Dominique Darmaun3, Jean-Christophe Rozé1,2,3. 1. Department of Neonatal Medicine, Nantes University Hospital, Nantes, France. 2. Epidemiologie Clinique, Centre d'Investigation Clinique (CIC004), Nantes University Hospital, Nantes, France. 3. INRA, UMR 1280 Physiologie des Adaptations Nutritionnelles, Nantes University Hospital, Nantes, France.
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 34 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.
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 34 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.
Authors: Jordan D Reis; Kristine Tolentino-Plata; Roy Heyne; L Steven Brown; Charles R Rosenfeld; Maria Caraig; Patti J Burchfield; Luc P Brion Journal: J Perinatol Date: 2021-03-26 Impact factor: 3.225
Authors: Ellen C Ingolfsland; Jacob L Haapala; Lauren A Buckley; Ellen W Demarath; Sixto F Guiang; Sara E Ramel Journal: Nutrients Date: 2019-12-27 Impact factor: 5.717