The association of growth impairment with neurodevelopmental outcome at eight years of age in very preterm children

Kan, Erick; Roberts, Gehan; Anderson, Peter J.; Doyle, Lex W.; the Victorian Infant Collaborative Study Group,

doi:10.1016/j.earlhumdev.2007.11.002

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Volume 84, Issue 6 , Pages 409-416, June 2008

The association of growth impairment with neurodevelopmental outcome at eight years of age in very preterm children☆

Erick Kan
- Department of Obstetrics and Gynaecology at The University of Melbourne, Australia
- Premature Infant Follow-up Programme at the Royal Women's Hospital, Australia
Gehan Roberts
- Department of Paediatrics at The University of Melbourne, Australia
- Premature Infant Follow-up Programme at the Royal Women's Hospital, Australia
- Murdoch Childrens Research Institute, Australia
Peter J. Anderson
- Department of Psychology at The University of Melbourne, Australia
- Premature Infant Follow-up Programme at the Royal Women's Hospital, Australia
- Murdoch Childrens Research Institute, Australia
Lex W. Doyle
- Department of Obstetrics and Gynaecology at The University of Melbourne, Australia
- Department of Paediatrics at The University of Melbourne, Australia
- Premature Infant Follow-up Programme at the Royal Women's Hospital, Australia
- Murdoch Childrens Research Institute, Australia
- Corresponding author. Department of Obstetrics and Gynaecology, The Royal Women's Hospital, 132 Grattan St, Carlton, 3053, Australia. Tel.: +61 3 9344 2151; fax: +61 3 9347 1761.
the Victorian Infant Collaborative Study Group
- ⁎Participants: Convenor; Lex W Doyle^a,b,d,e, Collaborators (in alphabetical order); Peter Anderson^c,d,e, Catherine Callanan^d, Elizabeth Carse^g, Dan Casalaz^f, Margaret P Charlton^g, Noni Davis^d, Julianne Duff^d, Geoffrey Ford^d, Marie Hayes^g, Elaine Kelly^d,f, Gillian Opie^f, Gehan Roberts^b,d, Andrew Watkins^f, Heather Woods^f, Victor Yu^g.

Received 8 October 2007; received in revised form 14 November 2007; accepted 16 November 2007.

Abstract

Background

The relative contributions of poor growth before and after birth in very preterm infants to subsequent outcomes at school-age are not certain.

Aims

To determine the associations between weight and head circumference, at birth and postnatally, with cognitive, academic and motor outcomes at age 8 years for very preterm children free of neurosensory impairment.

Study design

This was a regional cohort study from the state of Victoria, Australia.

Subjects

179 very preterm infants (<28 weeks' gestational age) born in 1991 and 1992 who were free of neurosensory impairment.

Outcome measures

At 8 years of age children had cognitive, academic and motor assessments. Weight and head circumference data were collected at birth, at the time of discharge (weight only), at 2 years of age and at 8 years of age, and growth restriction was calculated using Z-scores (standard deviation scores) relative to the expected mean for age.

Results

Very preterm children were significantly lighter and had smaller head circumferences than the reference group at all ages. Weight at any age was mostly unrelated to any outcomes. While head circumference at birth was not related to school-aged outcomes, smaller head circumferences at ages 2 and 8 years were associated with poorer performance in most outcome measures. Catch-up growth in weight in early childhood was not associated with 8-year outcomes.

Conclusions

Intrauterine growth restriction was not substantially associated with neurodevelopmental status at age 8. Weight after birth had little influence, but head circumference became more important in early childhood.

Keywords: Intrauterine growth restriction, Preterm, Growth, IQ, Cognitive function, Educational achievement, Motor function