Does Growth Velocity Affect Associations between Birth Weight and Neurodevelopment for Infants Born Very Preterm? - 08/09/23

Doi : 10.1016/j.jpeds.2023.113531

Thibaut Sériès, DPsy ^1,^{^{∗
Contributed equally.}}, Mireille Guillot, MD, MSc ^2,^{^{∗
Contributed equally.}}, Georgina Angoa, MSc ², Etienne Pronovost, BSc ², Aissatou Bintou Khairy Thilor Ndiaye, MSc ², Ibrahim Mohamed, MD, PhD ³, David Simonyan, MSc ⁴, Pascal M. Lavoie, MD, PhD ⁵, Anne Synnes, MDCM, MHSc ⁵, Isabelle Marc, MD, PhD ^2,^⁎
and the
MOBYDIck trial group^{^†}
A list of the MOBYDIck trial group members and affiliations is available at www.jpeds.com (Appendix).
Jehier Afifi, MD, Julie Bartholomew, MD, Georges Caouette, MD, MSc, Zenon Cieslak, MD, Cecilia de Cabo, MD, Thierry Daboval, MD, William D. Fraser, MD, Mireille Guillot, MD, MSc, Leonora Hendson, MD, Faiza Khurshid, MD, Thierry Lacaze-Masmonteil, MD, PhD, Pascal M. Lavoie, MD, PhD, Bodil Larsen, PhD, Brigitte Lemyre, MD, Isabelle Marc, MD, PhD, Benoît Mâsse, PhD, Edith Massé, MD, Ibrahim Mohamed, MD, PhD, Anne Monique Nuyt, MD, François Olivier, MD, Gustavo Pelligra, MD, Thérèse Perreault, MD, Bruno Piedboeuf, MD, Mosarrat Qureshi, MD, Chelsea Ruth, MD, MSc, Lannae Strueby, MD, Anne Synnes, MD, Kamran Yusuf, MD

¹ School of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
² Department of Pediatrics, Faculty of Medicine, Centre Hospitalier Universitaire de Québec-Université Laval, Québec, Canada
³ Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, Canada
⁴ Clinical and Evaluative Research platform, Centre de recherche du Centre Hospitalier Universitaire de Québec-Université Laval, Québec, Canada
⁵ Division of Neonatology, Department of Pediatrics, University of British Columbia, Vancouver, Canada

^∗Reprint requests: Isabelle Marc, MD, PhD, Department of Pediatrics, CHU de Québec-Université Laval, 2705 Boulevard Laurier, Québec, QC, Canada, G1V 4G2.Department of PediatricsCHU de Québec-Université Laval2705 Boulevard LaurierQuébecQCG1V 4G2Canada

Abstract

Objective

To determine how neonatal growth velocity affects the association between birth weight and neurodevelopmental outcomes in infants born preterm.

Study design

This study is a secondary analysis of the Maternal Omega-3 Supplementation to Reduce Bronchopulmonary Dysplasia in Very Preterm Infants (MOBYDIck) randomized multicenter trial conducted in breastfed infants born at <29 weeks of gestation, whose mothers were supplemented with docosahexaenoic acid or placebo during the neonatal period. Neurodevelopmental outcomes were assessed at 18-22 months of corrected age using the Bayley-III cognitive and language composite scores. The role of neonatal growth velocity was assessed with causal mediation and linear regression models. Subgroup analyses were stratified by birth weight z-score categories (<25th, ≥25th-≤75th, and >75th percentiles).

Results

Neurodevelopmental outcomes were available for 379 children (mean gestational age, 26.7 ± 1.5 weeks). Growth velocity partially mediated the relationships between birth weight and cognitive (β = −1.1; 95% CI, −2.2 to −0.02; P = .05) and language scores (β = −2.1; 95% CI, −3.3 to −0.8; P = .002). An increase by 1 g/kg/day in growth velocity was associated with an increase by 1.1 point in the cognitive score (95% CI, −0.03 to 2.1; P = .06) and 1.9 point in the language score (95% CI, 0.7 to 3.1; P = .001), after adjustment for birth weight z-score. For children with birth weight <25th percentile, a 1 g/kg/day increase in growth velocity was associated with an increase by 3.3 points in the cognitive score (95% CI, 0.5 to 6.0; P = .02) and 4.1 points in the language score (95% CI, 1.3 to 7.0; P = .004).

Conclusions

Postnatal growth velocity mediated the relationship between birth weight and neurodevelopmental performance, with larger effects for children with lower birth weight.

Trial registration

Clinicaltrials.gov identifier: NCT02371460.

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Keywords : Weight velocity, growth, newborn, cognition, language

Abbreviations : Bayley-III

Plan

Methods

Study Design

Participants

Outcomes and Exposure

Statistical Analyses

Results

Participant Characteristics

Associations between Growth Velocity, Birth Weight Z-score, and Neurodevelopmental Outcomes

Discussion

Data Statement

Prior presentation of study data: These data were presented at the Congrès provincial de la recherche mère-enfant, Québec, Canada, November 5, 2021; and at the Canadian Psychological Association 2022 National Annual Convention, Calgary, Alberta, Canada, June 17-19, 2022.

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Does Growth Velocity Affect Associations between Birth Weight and Neurodevelopment for Infants Born Very Preterm? - 08/09/23

Abstract

Objective

Study design

Results

Conclusions

Trial registration

Plan

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