Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada.
Neonatal Follow-Up Program, BC Women's Hospital, Vancouver, Canada.
Early Hum Dev. 2022 Oct;173:105647. doi: 10.1016/j.earlhumdev.2022.105647. Epub 2022 Aug 7.
Infants born extremely preterm are at high risk for early feeding difficulties, as well as poor neurodevelopmental outcomes in childhood. Feeding, a complex motor skill, may be predictive of later neuromotor outcomes.
To determine the relationship between feeding behaviours of extremely preterm-born infants (<28 weeks gestational age) at 4-months corrected age (CA) and neurodevelopmental outcomes at 4-5 years.
Retrospective cohort design with prospectively collected data.
Infants born extremely preterm from September 1999 - October 2013 [n = 412, mean gestational age 25.4 (1.3) weeks; mean birth weight 771 (168) grams]. Oral feeding was assessed at 4-months CA by an experienced occupational therapist; infants were classified as either having poor suck-swallow ('feeding difficulties') or no feeding difficulties.
Motor outcomes were assessed at 4-5 years using the Movement Assessment Battery for Children (MABC). Children were categorized as: (1) typical motor development (TMD; n = 214); (2) Developmental Coordination Disorder (DCD; n = 116); or (3) major neurodevelopmental disorder (MND; n = 82).
Feeding behaviour at 4-months CA predicted DCD (OR = 2.95, CI 1.13-7.68) and MND (OR = 3.67, CI 1.35-9.96) after controlling for confounders. Infants with feeding difficulties were more likely to be diagnosed with DCD (40 % of poor feeders) or MND (36 %) at 4-5 years, compared to infants without feeding issues.
Early feeding behaviours significantly predicted motor outcomes at 4-5 years. Infants born extremely preterm with early feeding difficulties should be identified as at high risk for poor motor outcomes later in childhood and screened for early diagnosis and intervention.
极早产儿在出生时存在早期喂养困难的高风险，并且在儿童时期存在神经发育不良的结局。喂养是一种复杂的运动技能，可能对后期神经运动结局具有预测性。
确定校正年龄 4 个月（CA）时极早产儿（<28 周胎龄）的喂养行为与 4-5 岁时神经发育结局之间的关系。
前瞻性收集数据的回顾性队列设计。
1999 年 9 月至 2013 年 10 月出生的极早产儿[n=412，平均胎龄 25.4（1.3）周；平均出生体重 771（168）克]。在 4 个月 CA 时，由经验丰富的职业治疗师评估口腔喂养情况；婴儿分为存在不良吸吮-吞咽（“喂养困难”）或无喂养困难。
在 4-5 岁时使用儿童运动评估测验（MABC）评估运动结果。将儿童分为：（1）典型运动发育（TMD；n=214）；（2）发育性协调障碍（DCD；n=116）；或（3）主要神经发育障碍（MND；n=82）。
校正混杂因素后，4 个月 CA 时的喂养行为可预测 DCD（OR=2.95，CI 1.13-7.68）和 MND（OR=3.67，CI 1.35-9.96）。与无喂养问题的婴儿相比，有喂养困难的婴儿在 4-5 岁时更有可能被诊断为 DCD（40%的不良喂养者）或 MND（36%）。
早期喂养行为显著预测了 4-5 岁时的运动结局。出生时极早产儿的早期喂养困难者应被视为存在儿童后期运动结局不良的高风险，并进行早期诊断和干预筛查。
