National Hospice Center, National Cancer Center, Goyang-si 10408, Korea.
Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul 03080, Korea.
Int J Environ Res Public Health. 2020 Apr 27;17(9):3022. doi: 10.3390/ijerph17093022.
Predicting developmental outcomes with growth measurement would be beneficial for primary healthcare or in developing countries with low medical resources. This study aimed to identify physical growth measures that indicate neurodevelopment in very preterm infants. Preterm infants, born at <32 weeks' gestation or weighing <1500 g, were included. We calculated the changes in z-score of weight, length, and head circumference (HC) at different time points: birth, postmenstrual age (PMA) 35 weeks, and 4 and 18 months corrected age (CA). We examined the relationship between growth and Bayley-III scores using linear regression. Among 122 infants, HC at 4 months CA and HC growth between PMA 35 weeks and 4 months CA showed a positive correlation with Bayley-III scores in appropriate-for-gestational-age infants (AGAs). Weight and length increases between birth and 18 months CA were also associated with AGAs' development. In small-for-gestational-age infants (SGAs), only birthweight's z-score was associated with improved neurodevelopmental outcomes. HC at 4 months CA was an important indicator of favorable neurodevelopmental outcomes, and head growth spurt between PMA 35 weeks and 4 months CA contributed to this benefit in preterm AGAs. The period and indices should be monitored differently for SGAs and AGAs.
生长测量预测发育结局有益于初级保健或医疗资源较低的发展中国家。本研究旨在确定能反映极早产儿神经发育情况的体格生长指标。纳入胎龄<32 周或出生体重<1500g 的早产儿。我们计算了不同时间点体重、身长和头围（HC）z 评分的变化：出生时、校正胎龄（CA）35 周时和 4 及 18 个月时。我们使用线性回归分析生长与贝利 III 评分之间的关系。在 122 名婴儿中，4 个月 CA 时的 HC 和 PMA 35 周至 4 个月 CA 期间的 HC 增长与适于胎龄儿（AGA）的贝利 III 评分呈正相关。出生至 18 个月 CA 期间体重和身长的增加也与 AGA 的发育相关。在小于胎龄儿（SGA）中，只有出生体重 z 评分与神经发育结局的改善相关。4 个月 CA 时的 HC 是神经发育结局良好的重要指标，PMA 35 周至 4 个月 CA 期间的 HC 快速增长有助于改善 PMA AGA 的结局。SGA 和 AGA 的监测时期和指标应有所不同。
