Growth, neurodevelopmental and health outcomes after extremely preterm birth.

The present study evaluated associations between changes in weight, length, and weight/length ratio during infancy and outcomes later in life among extremely preterm individuals.

It enrolled the participants in the Extremely Low Gestational Age Newborn (ELGAN) study, measured their weight and length at discharge from the neonatal intensive care unit (NICU) and at age two years, and evaluated neurocognitive, psychiatric, and health outcomes at age ten years and 15 years. It also estimated associations between gains in weight, length, and weight/length ratio z-scores between discharge and two years and outcomes at 10 and 15 years. The study defined High gain as the top quintile of change; low gain as the bottom quintile of change.

The study observed-

• High weight and weight/length gains showed an association with greater odds of obesity at ten years but not at 15 years. 
• These associations existed only for females. 
• High gain in length z-score showed an association with lower odds of obesity at 15 years. 
• High gains in growth measures and more favorable neurocognitive or psychiatric outcomes showed an association with high gain in weight/length and lower odds of cognitive impairment at age ten years.

This study shows that during the two years after NICU discharge, females born extremely preterm with high gains in weight/length or weight have greater odds of obesity at ten years but not at 15 years. Infants with high growth gains in the two years after NICU discharge have neurocognitive and psychiatric outcomes in middle childhood and adolescence, similar to infants with lower gains in weight and weight/length.

O’Shea TM, Register HM, Yi JX, et al., Growth During Infancy After Extremely Preterm Birth: Associations with Later Neurodevelopmental and Health Outcomes. The Journal of Pediatrics. 2023;252:40-47.E5. DOI:https://doi.org/10.1016/j.jpeds.2022.08.015