title: Association between neonatal morbidities and head growth from birth until discharge in very-low-birthweight infants born preterm: a population-based study.
abstract: OBJECTIVE
  To evaluate the possible association between major neonatal morbidities and poor head growth from birth to discharge home in very-low-birthweight (VLBW) infants born preterm.
  
  
  METHODS
  Population-based observational study comprising 12 992 infants (6340 male, 6652 female) of 24 to 32 weeks' gestation, and birthweight ≤1500g. Severe head growth failure (HGF) was defined as a decrease in head circumference z-score >2 z-scores, and moderate HGF as a decrease of 1 to 2 z-scores. Multinomial logistic regression analysis was applied to determine morbidities associated with HGF.
  
  
  RESULTS
  Severe HGF occurred in 4.5% and moderate HGF in 20.9% of infants. Each unit increase in head circumference z-score at birth was associated with increased odds for severe and moderate HGF (odds ratios [OR] 5.29, 95% confidence intervals [CI] 4.67-6.00, and OR 2.38, 95% CI 2.23-2.54 respectively). Both severe and moderate HGF were associated with respiratory distress syndrome (OR 2.03, 95% CI 1.58-2.62, and OR 1.66, 95% CI 1.48-1.85 respectively); bronchopulmonary dysplasia (OR 3.38, 95% CI 2.33-4.91, and OR 1.87, 95% CI 1.52-2.30 respectively); necrotizing enterocolitis (OR 2.89, 95% CI 2.04-4.09, and OR 1.72, 95% CI 1.38-2.16 respectively), and sepsis (OR 2.06, 95% CI 1.69-2.50, and OR 1.38, 95% CI 1.24-1.53 respectively).
  
  
  CONCLUSIONS
  Major neonatal morbidities were associated with HGF in VLBW infants born preterm. Identification of whether this is a direct effect of these morbidities or mediated through nutritional or growth factors may enable interventions to improve postnatal head growth of infants born preterm.
authors.affiliation: Department of Neonatology, Meir Hospital, Sapir Medical Center, Kfar Saba, Israel. regevdr@netvision.net.il.|Sackler Medical School, Tel Aviv University, Tel Aviv, Israel. regevdr@netvision.net.il.
authors.forename: Rivka H
authors.initials: RH
authors.lastname: Regev
authors.affiliation: Department of Neonatology, Meir Hospital, Sapir Medical Center, Kfar Saba, Israel.|Sackler Medical School, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Shmuel
authors.initials: S
authors.lastname: Arnon
authors.affiliation: Department of Neonatology, Meir Hospital, Sapir Medical Center, Kfar Saba, Israel.|Sackler Medical School, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ita
authors.initials: I
authors.lastname: Litmanovitz
authors.affiliation: Department of Neonatology, Meir Hospital, Sapir Medical Center, Kfar Saba, Israel.
authors.forename: Sofia
authors.initials: S
authors.lastname: Bauer-Rusek
authors.affiliation: Women and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel.
authors.forename: Valentina
authors.initials: V
authors.lastname: Boyko
authors.affiliation: Sackler Medical School, Tel Aviv University, Tel Aviv, Israel.|Women and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel.
authors.forename: Liat
authors.initials: L
authors.lastname: Lerner-Geva
authors.affiliation: Sackler Medical School, Tel Aviv University, Tel Aviv, Israel.|Women and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, Israel.
authors.forename: Brian
authors.initials: B
authors.lastname: Reichman
mesh_terms: D015897:Comorbidity; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology*; D006257:Head / Q000254:growth & development*; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology*; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007557:Israel / Q000453:epidemiology; D008297:Male; D013997:Time Factors