title: Weight Status in the First 2 Years of Life and Neurodevelopmental Impairment in Extremely Low Gestational Age Newborns.
abstract: OBJECTIVE
  To examine the extent to which weight gain and weight status in the first 2 years of life relate to the risk of neurodevelopmental impairment in extremely preterm infants.
  
  
  METHODS
  In a cohort of 1070 infants born between 23 and 27 weeks' gestation, we examined weight gain from 7-28 days of life (in quartiles) and weight z-score at 12 and 24 months corrected age (in 4 categories: <-2; ≥-2, <-1; ≥1, <1; and ≥1) in relation to these adverse neurodevelopmental outcomes: Bayley-II mental development index <55, Bayley-II psychomotor development index <55, cerebral palsy, Gross Motor Function Classification System ≥1 (cannot walk without assistance), microcephaly. We adjusted for confounders in logistic regression, stratified by sex, and performed separate analyses including the entire sample, and excluding children unable to walk without assistance (motor impairment).
  
  
  RESULTS
  Weight gain in the lowest quartile from 7-28 days was not associated with higher risk of adverse outcomes. Children with a 12-month weight z-score <-2 were at increased risk for all adverse outcomes in girls, and for microcephaly and Gross Motor Function Classification System ≥1 in boys. However, excluding children with motor impairment attenuated all associations except that of weight z-score <-2 with microcephaly in girls. Similarly, most associations of low weight z-score at 24 months with adverse outcomes were attenuated with exclusion of children with motor impairment.
  
  
  CONCLUSIONS
  Excluding children who have gross motor impairment appears to eliminate the association of low weight status with neurodevelopmental impairments at 2 years in extremely preterm infants.
authors.affiliation: Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA.
authors.forename: Mandy B
authors.initials: MB
authors.lastname: Belfort
authors.affiliation: Division of Pediatric Neurology, Boston Medical Center, Boston, MA.
authors.forename: Karl C K
authors.initials: KCK
authors.lastname: Kuban
authors.affiliation: Department of Pediatrics, Wake Forest University, Winston-Salem, NC.
authors.forename: T Michael
authors.initials: TM
authors.lastname: O'Shea
authors.affiliation: Neuroepidemiology Unit, Department of Neurology, Boston Children's Hospital, Boston, MA.
authors.forename: Elizabeth N
authors.initials: EN
authors.lastname: Allred
authors.affiliation: Section of Neonatal-Perinatal Medicine, Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Ehrenkranz
authors.affiliation: Department of Pediatrics, Division of Neonatology, Eastern Carolina University School of Medicine, Greenville, NC.
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Engelke
authors.affiliation: Neuroepidemiology Unit, Department of Neurology, Boston Children's Hospital, Boston, MA.
authors.forename: Alan
authors.initials: A
authors.lastname: Leviton
mesh_terms: D001835:Body Weight; D002657:Child Development; D002658:Developmental Disabilities / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D016015:Logistic Models; D008297:Male; D065886:Neurodevelopmental Disorders / Q000453:epidemiology / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors; D015430:Weight Gain