Weight Status in the First 2 Years of Life and Neurodevelopmental Impairment in Extremely Low Gestational Age Newborns

Mandy B. Belfort, Karl C K Kuban, T. Michael O'Shea, Elizabeth N. Allred, Richard A. Ehrenkranz, Stephen C. Engelke, Alan Leviton, Kathleen Lee, Anne McGovern, Jill Gambardella, Susan Ursprung, Ruth Blomquist Kristen Ecklund, Haim Bassan, Samantha Butler, Adré Duplessis, Cecil Hahn, Catherine Limperopoulos, Omar Khwaja, Janet S. Soul, Bhavesh ShahKaren Christianson, Frederick Hampf, Herbert Gilmore, Susan McQuiston, Camilia R. Martin, Colleen Hallisey, Caitlin Hurley, Miren Creixell, Jane Share, Linda J. Van Marter, Sara Durfee, Robert M. Insoft, Jennifer G. Wilson, Maureen Pimental, Sjirk J. Westra, Kalpathy Krishnamoorthy, Cynthia Cole, John M. Fiascone, Janet Madden, Ellen Nylen, Anne Furey, Roy McCauley, Paige T. Church, Cecelia Keller, Karen J. Miller, Francis Bednarek, Mary Naples, Beth Powers, Leslie Caldarelli, Sunila E. O'Connor, Extremely Low Gestational Age Newborn (ELGAN) Study Investigators

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)30-35.e2
JournalJournal of Pediatrics
Volume168
DOIs
StatePublished - Jan 1 2016

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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