TY - JOUR
T1 - Weight Status in the First 2 Years of Life and Neurodevelopmental Impairment in Extremely Low Gestational Age Newborns
AU - Belfort, Mandy B.
AU - Kuban, Karl C K
AU - O'Shea, T. Michael
AU - Allred, Elizabeth N.
AU - Ehrenkranz, Richard A.
AU - Engelke, Stephen C.
AU - Leviton, Alan
AU - Lee, Kathleen
AU - McGovern, Anne
AU - Gambardella, Jill
AU - Ursprung, Susan
AU - Kristen Ecklund, Ruth Blomquist
AU - Bassan, Haim
AU - Butler, Samantha
AU - Duplessis, Adré
AU - Hahn, Cecil
AU - Limperopoulos, Catherine
AU - Khwaja, Omar
AU - Soul, Janet S.
AU - Shah, Bhavesh
AU - Christianson, Karen
AU - Hampf, Frederick
AU - Gilmore, Herbert
AU - McQuiston, Susan
AU - Martin, Camilia R.
AU - Hallisey, Colleen
AU - Hurley, Caitlin
AU - Creixell, Miren
AU - Share, Jane
AU - Van Marter, Linda J.
AU - Durfee, Sara
AU - Insoft, Robert M.
AU - Wilson, Jennifer G.
AU - Pimental, Maureen
AU - Westra, Sjirk J.
AU - Krishnamoorthy, Kalpathy
AU - Cole, Cynthia
AU - Fiascone, John M.
AU - Madden, Janet
AU - Nylen, Ellen
AU - Furey, Anne
AU - McCauley, Roy
AU - Church, Paige T.
AU - Keller, Cecelia
AU - Miller, Karen J.
AU - Bednarek, Francis
AU - Naples, Mary
AU - Powers, Beth
AU - Caldarelli, Leslie
AU - O'Connor, Sunila E.
AU - Extremely Low Gestational Age Newborn (ELGAN) Study Investigators
N1 - Funding Information:
Supported by the National Institute of Neurological Disorders and Stroke (5U01NS040069-05 and 2R01NS040069-06A2), the National Eye Institute (1-R01-EY021820-01), and the National Institute of Child Health and Human Development (5P30HD018655-28). M.B. was supported by the National Institute of Diabetes, Digestive, and Kidney Disorders (K23DK083817). The authors declare no conflicts of interest.
Funding Information:
Supported by the National Institute of Neurological Disorders and Stroke ( 5U01NS040069-05 and 2R01NS040069-06A2 ), the National Eye Institute ( 1-R01-EY021820-01 ), and the National Institute of Child Health and Human Development ( 5P30HD018655-28 ). M.B. was supported by the National Institute of Diabetes, Digestive, and Kidney Disorders ( K23DK083817 ). The authors declare no conflicts of interest.
Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Objective To examine the extent to which weight gain and weight status in the first 2 years of life relate to the risk of neurodevelopmental impairment in extremely preterm infants. Study design In a cohort of 1070 infants born between 23 and 27 weeks' gestation, we examined weight gain from 7-28 days of life (in quartiles) and weight z-score at 12 and 24 months corrected age (in 4 categories: <-2; ≥-2, <-1; ≥1, <1; and ≥1) in relation to these adverse neurodevelopmental outcomes: Bayley-II mental development index <55, Bayley-II psychomotor development index <55, cerebral palsy, Gross Motor Function Classification System ≥1 (cannot walk without assistance), microcephaly. We adjusted for confounders in logistic regression, stratified by sex, and performed separate analyses including the entire sample, and excluding children unable to walk without assistance (motor impairment). Results Weight gain in the lowest quartile from 7-28 days was not associated with higher risk of adverse outcomes. Children with a 12-month weight z-score <-2 were at increased risk for all adverse outcomes in girls, and for microcephaly and Gross Motor Function Classification System ≥1 in boys. However, excluding children with motor impairment attenuated all associations except that of weight z-score <-2 with microcephaly in girls. Similarly, most associations of low weight z-score at 24 months with adverse outcomes were attenuated with exclusion of children with motor impairment. Conclusion Excluding children who have gross motor impairment appears to eliminate the association of low weight status with neurodevelopmental impairments at 2 years in extremely preterm infants.
AB - Objective To examine the extent to which weight gain and weight status in the first 2 years of life relate to the risk of neurodevelopmental impairment in extremely preterm infants. Study design In a cohort of 1070 infants born between 23 and 27 weeks' gestation, we examined weight gain from 7-28 days of life (in quartiles) and weight z-score at 12 and 24 months corrected age (in 4 categories: <-2; ≥-2, <-1; ≥1, <1; and ≥1) in relation to these adverse neurodevelopmental outcomes: Bayley-II mental development index <55, Bayley-II psychomotor development index <55, cerebral palsy, Gross Motor Function Classification System ≥1 (cannot walk without assistance), microcephaly. We adjusted for confounders in logistic regression, stratified by sex, and performed separate analyses including the entire sample, and excluding children unable to walk without assistance (motor impairment). Results Weight gain in the lowest quartile from 7-28 days was not associated with higher risk of adverse outcomes. Children with a 12-month weight z-score <-2 were at increased risk for all adverse outcomes in girls, and for microcephaly and Gross Motor Function Classification System ≥1 in boys. However, excluding children with motor impairment attenuated all associations except that of weight z-score <-2 with microcephaly in girls. Similarly, most associations of low weight z-score at 24 months with adverse outcomes were attenuated with exclusion of children with motor impairment. Conclusion Excluding children who have gross motor impairment appears to eliminate the association of low weight status with neurodevelopmental impairments at 2 years in extremely preterm infants.
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U2 - 10.1016/j.jpeds.2015.09.036
DO - 10.1016/j.jpeds.2015.09.036
M3 - Article
C2 - 26470687
AN - SCOPUS:84955690561
SN - 0022-3476
VL - 168
SP - 30-35.e2
JO - journal of pediatrics
JF - journal of pediatrics
ER -