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Head Growth Trajectory and Neurodevelopmental Outcomes in Preterm Neonates.
- Source :
-
Pediatrics . Jul2017, Vol. 140 Issue 1, p1-10. 10p. - Publication Year :
- 2017
-
Abstract
- OBJECTIVES: To evaluate the association between head growth (HG) during neonatal and postdischarge periods and neurodevelopmental outcomes of preterm neonates of <29 weeks gestational age. METHODS: We conducted a retrospective cohort study of infants <29 weeks gestational age admitted between 2009 and 2011 to participating Canadian Neonatal Network units and followed by Canadian Neonatal Follow-Up Network clinics. Differences in head circumference (ΔHC) z score were calculated for 3 time periods, which include admission to discharge, discharge to follow-up at 16-36 months, and admission to follow-up. These were categorized in 1 reference group (ΔHC z score between -1 and +1) and 4 study groups (ΔHC z score of <-2, between -2 to -1, +1 to +2, and >+2). Neurodevelopmental outcomes were compared with the reference group. RESULTS: 1973 infants met the inclusion criteria. Poor HG occurred frequently during the NICU admission (ΔHC z score <-2 in 24% infants versus 2% infants post-discharge) with a period of "catch-up" growth postdischarge. Significant neurodevelopmental impairment was higher in infants with the poorest HG from admission to follow-up (adjusted odds ratio 2.18, 95% confidence interval 1.50-3.15), specifically cognitive and motor delays. Infants with poor initial HG and catch-up postdischarge have a lower adjusted odds ratio of significant neurodevelopmental impairment (0.35, 95% CI 0.16-0.74). Infants with poor HG received a longer duration of parenteral nutrition and mechanical ventilation and had poor weight gain. CONCLUSIONS: Poor HG during the neonatal and postdischarge periods was associated with motor and cognitive delays at 16 to 36 months. [ABSTRACT FROM AUTHOR]
- Subjects :
- *CEPHALOMETRY
*COGNITION disorders in children
*COMPARATIVE studies
*CONFIDENCE intervals
*GESTATIONAL age
*PREMATURE infants
*INFANT development
*LONGITUDINAL method
*MOVEMENT disorders
*NEONATAL intensive care
*NEUROLOGIC examination
*NEONATAL intensive care units
*RETROSPECTIVE studies
*ODDS ratio
*CHILDREN
Subjects
Details
- Language :
- English
- ISSN :
- 00314005
- Volume :
- 140
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 124021672
- Full Text :
- https://doi.org/10.1542/peds.2017-0216