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Growth During Infancy After Extremely Preterm Birth: Associations with Later Neurodevelopmental and Health Outcomes - 14/12/22

Doi : 10.1016/j.jpeds.2022.08.015 
T. Michael O’Shea, MD, MPH 1, Hannah M. Register, BS 1, Joe X. Yi, BS 2, Elizabeth T. Jensen, MPH, PhD 3, Robert M. Joseph, PhD 4, Karl C.K. Kuban, MD, SMEpi 5, Jean A. Frazier, MD 6, Lisa Washburn, MD 7, Mandy Belfort, MD, MPH 8, Andrew M. South, MD, MS 3, 7, Hudson P. Santos, PhD 9, Jeffrey Shenberger, MD 7, Eliana M. Perrin, MD, MPH 10, Amanda L. Thompson, PhD, MPH 11, Rachana Singh, MD, MS 12, Julie Rollins, MA 1, Semsa Gogcu, MD, MPH 7, Keia Sanderson, MD, MS 13, Charles Wood, MD, MPH 14, Rebecca C. Fry, PhD 15
for the

ELGAN-ECHO Pulmonary/Obesity Group

1 Department of Pediatrics, The University of North Carolina, Chapel Hill, NC 
2 Frank Porter Graham Child Development Institute, The University of North Carolina, Chapel Hill, NC 
3 Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC 
4 Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA 
5 Department of Pediatrics and Neurology, Boston Medical Center, Boston, MA 
6 Eunice Kennedy Shriver Center and Department of Psychiatry, University of Massachusetts Chan Medical Center, Worcester, MA 
7 Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC 
8 Department of Pediatric Newborn Medicine, Harvard Medical School, Boston, MA 
9 School of Nursing & Health Studies, University of Miami, Coral Gables, FL 
10 Department of Pediatrics, Johns Hopkins University School of Medicine and Nursing, Baltimore, MD 
11 Department of Anthropology, The University of North Carolina, Chapel Hill, NC 
12 Department of Pediatrics, Tufts Children’s Hospital, Tufts University School of Medicine, Boston, MA 
13 Department of Internal Medicine, University of North Carolina School of Medicine, Chapel Hill, NC 
14 Department of Pediatrics, Duke University School of Medicine, Durham, NC 
15 Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina, Chapel Hill, NC 

Abstract

Objective

To evaluate associations between changes in weight, length, and weight/length ratio during infancy and outcomes later in life among individuals born extremely preterm.

Study design

Among participants in the Extremely Low Gestational Age Newborn (ELGAN) study, we measured weight and length at discharge from the neonatal intensive care unit (NICU) and at age 2 years and evaluated neurocognitive, psychiatric, and health outcomes at age 10 years and 15 years. Using multivariable logistic regression, we estimated associations between gains in weight, length, and weight/length ratio z-scores between discharge and 2 years and outcomes at 10 and 15 years. High gain was defined as the top quintile of change; low gain, as the bottom quintile of change.

Results

High gains in weight and weight/length were associated with greater odds of obesity at 10 years, but not at 15 years. These associations were found only for females. High gain in length z-score was associated with lower odds of obesity at 15 years. The only association found between high gains in growth measures and more favorable neurocognitive or psychiatric outcomes was between high gain in weight/length and lower odds of cognitive impairment at age 10 years.

Conclusions

During the 2 years after NICU discharge, females born extremely preterm with high gains in weight/length or weight have greater odds of obesity at 10 years, but not at 15 years. Infants with high growth gains in the 2 years after NICU discharge have neurocognitive and psychiatric outcomes in middle childhood and adolescence similar to those of infants with lower gains in weight and weight/length.

Le texte complet de cet article est disponible en PDF.

Keywords : growth, obesity, preterm birth, asthma, neurodevelopment

Abbreviations : ADHD, BMI, CSI-4, ELGAN, IHDP, MINI-KID, NICU, NTCB, WASI-II


Plan


 This study was supported by grants from the National Institute of Neurological Disorders and Stroke (5U01 NS040069-05, to A.L. and 2R01 NS040069-06A2, to K.K.); the Office of the National Institutes of Health Director (UH3OD023348, to T.O.), National Institute of Child Health and Human Development (5R01 HD092374-05, to T.O. and R.F.); and National Heart, Lung, and Blood Institute (K23 HL148394, to A.S., L40 HL148910, to A.S., and R01 HL146818, to L.W.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors declare no conflicts of interest.
 Acknowledgment information is available at www.jpeds.com.


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P. 40 - janvier 2023 Retour au numéro
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