Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA.
Pediatr Res. 2018 Nov;84(5):713-718. doi: 10.1038/s41390-018-0158-x. Epub 2018 Aug 21.
Very preterm (VPT) infants are at-risk for altered growth, slower speed of processing (SOP), and hypertension. This study assesses the relationship between postnatal body composition (BC), neurodevelopment (indexed by SOP), and blood pressure (BP) in VPT infants.
Thirty-four VPT infants underwent weekly measurements and BC testing until discharge and post-discharge at 4 mos CGA and 4 yrs. At post-discharge visits, SOP was assessed using visual evoked potentials and the NIH Toolbox; BP was also measured.
In-hospital rate of weight, length and fat-free mass (FFM) gains were associated with faster SOP at 4 yrs. Higher rate of gains in weight and FFM from discharge to 4 mos CGA were associated with faster SOP at 4 mos CGA, while higher fat mass (FM) gains during the same time were positively associated with BP at 4 yrs. BC at 4 yrs nor gains beyond 4 mos CGA were associated with outcomes.
In VPT infants, early FFM gains are associated with faster SOP, whereas post-discharge FM gains are associated with higher BPs at 4 yrs. This shows birth to 4 mos CGA is a sensitive period for growth and its relation to neurodevelopmental and metabolic outcomes. Close monitoring and early nutritional adjustments to optimize quality of gains may improve outcomes.
极早产儿（VPT）存在生长改变、处理速度较慢（SOP）和高血压的风险。本研究评估了 VPT 婴儿的产后身体成分（BC）、神经发育（以 SOP 为指标）和血压（BP）之间的关系。
34 名 VPT 婴儿接受了每周的测量和 BC 测试，直至出院，并在 4 个月校正年龄（CGA）和 4 岁时进行了出院后随访。在出院后的随访中，使用视觉诱发电位和 NIH 工具包评估 SOP；同时还测量了 BP。
住院期间体重、身高和去脂体重（FFM）的增长速度与 4 岁时 SOP 较快有关。从出院到 4 个月 CGA 时体重和 FFM 增长速度较快与 4 个月 CGA 时 SOP 较快有关，而在此期间 FM 增长速度较快与 4 岁时的 BP 呈正相关。4 岁时的 BC 或 4 个月 CGA 后无增长与结果无关。
在 VPT 婴儿中，早期 FFM 增长与 SOP 较快有关，而出院后 FM 增长与 4 岁时的 BP 较高有关。这表明从出生到 4 个月 CGA 是生长及其与神经发育和代谢结果的敏感时期。密切监测和早期营养调整以优化增长质量可能会改善结果。
