Department of Neonatology, University Children's Hospital Basel UKBB, University of Basel, 4056, Basel, Switzerland.
Division of Neonatology, University Children's Hospital, University of Bern, Berne, Switzerland.
Eur J Pediatr. 2022 Oct;181(10):3673-3681. doi: 10.1007/s00431-022-04567-9. Epub 2022 Jul 22.
To assess the association between postnatal growth and neurodevelopment at the age of 2 years in extremely low gestational age newborns (ELGAN, < 28 weeks' gestation). Retrospective population-based cohort study including all live born ELGAN in 2006-2012 in Switzerland. Growth parameters (weight, length, head circumference, body mass index) were assessed at birth, at hospital discharge home, and 2-year follow-up (FU2). Unadjusted and adjusted regression models assessed associations between growth (birth to hospital discharge and birth to FU2) and neurodevelopment at FU2. A total of 1244 infants (mean GA 26.5 ± 1.0 weeks, birth weight 853 ± 189 g) survived to hospital discharge and were included in the analyses. FU2 was documented for 1049 (84.3%) infants. The mean (± SD) mental and a psychomotor development index at 2FU were 88.9 (± 18.0) and 86.9 (± 17.7), respectively. Moderate or severe neurodevelopmental impairment was documented in 23.2% of patients. Changes of z-scores between birth and discharge and between birth and FU2 for weight were - 1.06 (± 0.85) and - 0.140 (± 1.15), for length - 1.36 (± 1.34), and - 0.40 (± 1.33), for head circumference - 0.61 (± 1.04) and - 0.76 (± 1.32) as well as for BMI 0.22 (± 3.36) and - 0.006 (± 1.45). Unadjusted and adjusted analyses showed that none of the four growth parameters was significantly associated with any of the three outcome parameters of neurodevelopment. This was consistent for both time intervals.
In the present population-based cohort of ELGAN, neither growth between birth and hospital discharge nor between birth and FU2 were significantly associated with neurodevelopment at age of 2 years.
• Studies assessing the association between growth and neurodevelopment in extremely low gestational age newborns (28 weeks' gestation) show conflicting results.
• Neither growth between birth and hospital discharge nor between birth and corrected age of 2 years were significantly associated with neurodevelopment at age of 2 years. • The role of postnatal growth as a predictor of neurodevelopmental outcome during infancy might be smaller than previously assumed.
评估极低出生体重儿（ELGAN，<28 周）出生后生长与 2 岁时神经发育之间的关系。
这是一项回顾性的基于人群的队列研究，纳入了 2006 年至 2012 年瑞士所有活产的 ELGAN。在出生时、出院回家时和 2 岁随访（FU2）时评估生长参数（体重、身长、头围、体重指数）。未调整和调整后的回归模型评估了出生至出院（birth to hospital discharge）和出生至 FU2（birth to FU2）期间生长与 FU2 时神经发育之间的关系。共有 1244 名婴儿（平均胎龄 26.5±1.0 周，出生体重 853±189g）存活至出院，并纳入分析。1049 名（84.3%）婴儿有 FU2 记录。FU2 时的平均（±标准差）精神和运动发育指数分别为 88.9（±18.0）和 86.9（±17.7）。23.2%的患者有中度或重度神经发育障碍。体重的 z 评分从出生到出院和从出生到 FU2 的变化分别为-1.06（±0.85）和-0.140（±1.15），身长为-1.36（±1.34），-0.40（±1.33），头围为-0.61（±1.04）和-0.76（±1.32），体重指数为 0.22（±3.36）和-0.006（±1.45）。未调整和调整分析均显示，四个生长参数中没有一个与神经发育的三个结果参数中的任何一个显著相关。这两个时间间隔的结果都是一致的。
在本项基于人群的 ELGAN 队列研究中，出生至出院和出生至 FU2 期间的生长均与 2 岁时的神经发育无显著相关性。
评估 28 周胎龄极低出生体重儿（ELGAN）生长与神经发育关系的研究结果相互矛盾。
出生至出院和出生至 2 年校正年龄期间的生长与 2 岁时的神经发育无显著相关性。出生后生长作为婴儿期神经发育结局的预测因子的作用可能比以前认为的要小。
