Postnatal growth in VLBW infants: significant association with neurodevelopmental outcome.
OBJECTIVE
To study the significance of growth status at birth and postnatal growth on neurodevelopmental outcome in very low birth weight (VLBW) infants.


METHODS
Growth and neurodevelopment were examined in 219 VLBW (<1250 g) children, 94 small for gestational age (SGA) (<10th percentile) and 125 appropriate for gestational age (AGA) (>10th percentile). Outcome at age 2 was assessed with the Bayley Scales of Infant Development (Mental Developmental Index [MDI], Psychomotor Developmental Index [PDI]) and a standardized neurologic examination.


RESULTS
SGA status was not associated with poor neurodevelopmental outcome. However, after adjustment for covariables including cerebral palsy (CP), SGA children with weight <10th percentile at age 2 had lower mean PDI than SGA children with catch-up growth to weight >10th percentile (mean [SD], 89.9 [17.4] versus 101.8 [14.5]; P<.001). AGA children with catch-down growth (weight <10th percentile at age 2) were, independent of CP, more likely to have lower mean MDI (94.9 vs 101.7, P=.05) and PDI (81.9 vs 95.1; P<.001) than AGA children remaining >10th percentile at age 2. They also more frequently had severe CP (22.9% vs 1.2%; P=.008).


CONCLUSIONS
In VLBW children, the course of postnatal growth rather than the appropriateness of weight for gestational age at birth determines later neurodevelopmental outcome.
Latal-Hajnal
Beatrice
B
Growth and Development Center, University Children's Hospital Zurich, Steinwiesstrasse 75, CH-8032 Zurich, Switzerland. Bea.Latal@kispi.unizh.ch
von Siebenthal
Kurt
K
Kovari
Helen
H
Bucher
Hans U
HU
Largo
Remo H
RH
D001835:Body Weight; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn / Q000254:growth & development; D007234:Infant, Premature / Q000254:growth & development*; D007236:Infant, Small for Gestational Age / Q000254:growth & development; D019102:Infant, Very Low Birth Weight / Q000254:growth & development*; D008297:Male; D011597:Psychomotor Performance / Q000502:physiology