title: Post-term growth and cognitive development at 5 years of age in preterm children: Evidence from a prospective population-based cohort.
abstract: While the effects of growth from birth to expected term on the subsequent development of preterm children has attracted plentiful attention, less is known about the effects of post-term growth. We aimed to delineate distinct patterns of post-term growth and to determine their association with the cognitive development of preterm children. Data from a prospective population-based cohort of 3,850 surviving infants born at less than 35 weeks of gestational age were used. Growth was assessed as the Body Mass Index (BMI) Z-scores at 3, 9, 18, 24, 36, 48, and 60 months. Cognitive development at five years of age was evaluated by the Global School Adaptation score (GSA). Latent class analysis was implemented to identify distinct growth patterns and logistic regressions based on propensity matching were used to evaluate the relationship between identified growth trajectories and cognitive development. Four patterns of post-term growth were identified: a normal group with a Z-score consistently around zero during childhood (n = 2,469; 64%); a group with an early rapid rise in the BMI Z-score, but only up to 2 years of age (n = 195; 5%); a group with a slow yet steady rise in the BMI Z-score during childhood (n = 510; 13%); and a group with a negative Z-score growth until 3 years of age (n = 676; 18%). The group with a slow yet steady rise in the BMI Z-score was significantly associated with low GSA scores. Our findings indicate heterogeneous post-term growth of preterm children, with potential for association with their cognitive development.
authors.affiliation: Department of Paediatric Medicine, Nantes University Hospital, Nantes, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Simon
authors.affiliation: INSERM CIC 1413, Clinical Investigation Center, Nantes University Hospital, Nantes, France.
authors.forename: Simon
authors.initials: S
authors.lastname: Nusinovici
authors.affiliation: Department of Paediatric Medicine, Nantes University Hospital, Nantes, France.
authors.forename: Cyril
authors.initials: C
authors.lastname: Flamant
authors.affiliation: Department of Endocrinology, l'Institut du Thorax, Nantes University Hospital, Nantes, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Cariou
authors.affiliation: Réseau "Grandir ensemble", Nantes University Hospital, Nantes, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Rouger
authors.affiliation: Department of Neonatal Medicine, Angers University Hospital, Angers, France.
authors.forename: Géraldine
authors.initials: G
authors.lastname: Gascoin
authors.affiliation: National Institute for Agricultural Research, UMR 1280 PHAN, Nantes University, Institut des Maladies de l'Appareil Digestif (IMAD), and CRNH-Ouest, Nantes, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Darmaun
authors.affiliation: Department of Paediatric Medicine, Nantes University Hospital, Nantes, France.|INSERM CIC 1413, Clinical Investigation Center, Nantes University Hospital, Nantes, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Rozé
authors.affiliation: INSERM CIC 1413, Clinical Investigation Center, Nantes University Hospital, Nantes, France.|INSERM UMR 1181 Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), Versailles Saint Quentin University, Villejuif, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Hanf
mesh_terms: D001724:Birth Weight; D015992:Body Mass Index; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D003071:Cognition / Q000502:physiology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development* / Q000523:psychology*; D007858:Learning / Q000502:physiology; D016015:Logistic Models; D008297:Male; D011446:Prospective Studies