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 Shah; Karen 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

doi:10.1016/j.jpeds.2015.09.036

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

Pediatrics

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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 language	English (US)
Pages (from-to)	30-35.e2
Journal	journal of pediatrics
Volume	168
DOIs	https://doi.org/10.1016/j.jpeds.2015.09.036
State	Published - Jan 1 2016

Funding

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. 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.

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health

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10.1016/j.jpeds.2015.09.036

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Belfort, M. B., Kuban, K. C. K., O'Shea, T. M., Allred, E. N., Ehrenkranz, R. A., Engelke, S. C., Leviton, A., Lee, K., McGovern, A., Gambardella, J., Ursprung, S., Kristen Ecklund, R. B., Bassan, H., Butler, S., Duplessis, A., Hahn, C., Limperopoulos, C., Khwaja, O., Soul, J. S., ... Extremely Low Gestational Age Newborn (ELGAN) Study Investigators (2016). Weight Status in the First 2 Years of Life and Neurodevelopmental Impairment in Extremely Low Gestational Age Newborns. journal of pediatrics, 168, 30-35.e2. https://doi.org/10.1016/j.jpeds.2015.09.036

@article{ad56b69b2dec4dc6a25bd7b91d96c3fe,

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

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.",

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

note = "Publisher Copyright: {\textcopyright} 2016 Elsevier Inc.",

year = "2016",

month = jan,

day = "1",

doi = "10.1016/j.jpeds.2015.09.036",

language = "English (US)",

volume = "168",

pages = "30--35.e2",

journal = "journal of pediatrics",

issn = "0022-3476",

publisher = "Mosby Inc.",

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Belfort, MB, Kuban, KCK, O'Shea, TM, Allred, EN, Ehrenkranz, RA, Engelke, SC, Leviton, A, Lee, K, McGovern, A, Gambardella, J, Ursprung, S, Kristen Ecklund, RB, Bassan, H, Butler, S, Duplessis, A, Hahn, C, Limperopoulos, C, Khwaja, O, Soul, JS, Shah, B, Christianson, K, Hampf, F, Gilmore, H, McQuiston, S, Martin, CR, Hallisey, C, Hurley, C, Creixell, M, Share, J, Van Marter, LJ, Durfee, S, Insoft, RM, Wilson, JG, Pimental, M, Westra, SJ, Krishnamoorthy, K, Cole, C, Fiascone, JM, Madden, J, Nylen, E, Furey, A, McCauley, R, Church, PT, Keller, C, Miller, KJ, Bednarek, F, Naples, M, Powers, B, Caldarelli, L , O'Connor, SE & Extremely Low Gestational Age Newborn (ELGAN) Study Investigators 2016, 'Weight Status in the First 2 Years of Life and Neurodevelopmental Impairment in Extremely Low Gestational Age Newborns', journal of pediatrics, vol. 168, pp. 30-35.e2. https://doi.org/10.1016/j.jpeds.2015.09.036

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

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 -

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

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