Postnatal growth restriction and neurodevelopment at 5 years of age: a European extremely preterm birth cohort study

Data de publicação: 01/09/2023 Data Ahead of Print: 01/03/2023

Autores da FMUP

José Henrique Dias Pinto De Barros

Autor

Participantes de fora da FMUP

El Rafei, R
Maier, RF
Jarreau, PH
Norman, M
Van Reempts, P
Van Heijst, A
Pedersen, P
Cuttini, M
Johnson, S
Costa, R
Zemlin, M
Draper, ES
Zeitlin, J
SHIPS Res Grp

Unidades de investigação

Ciências da Saúde Pública e Forenses, e Educação Médica

Abstract

Objective To investigate whether extrauterine growth restriction (EUGR) during the neonatal hospitalisation by sex among extremely preterm (EPT) infants is associated with cerebral palsy (CP) and cognitive and motor abilities at 5 years of age. Study design Population-based cohort of births <28 weeks of gestation with data from obstetric and neonatal records and parental questionnaires and clinical assessments at 5 years of age. Setting 11 European countries. Patients 957 EPT infants born in 2011-2012. Main outcomes EUGR at discharge from the neonatal unit was defined as (1) the difference between Z-scores at birth and discharge with <-2 SD as severe, -2 to -1 SD as moderate using Fenton's growth charts (Fenton) and (2) average weight-gain velocity using Patel's formula in grams (g) per kilogram per day (Patel) with <11.2 g (first quartile) as severe, 11.2-12.5 g (median) as moderate. Five-year outcomes were: a CP diagnosis, intelligence quotient (IQ) using the Wechsler Preschool and Primary Scales of Intelligence tests and motor function using the Movement Assessment Battery for Children, second edition. Results 40.1% and 33.9% children were classified as having moderate and severe EUGR, respectively, by Fenton and 23.8% and 26.3% by Patel. Among children without CP, those with severe EUGR had lower IQ than children without EUGR (-3.9 points, 95% Confidence Interval (CI)=-7.2 to -0.6 for Fenton and -5.0 points, 95% CI=-8.2 to -1.8 for Patel), with no interaction by sex. No significant associations were observed between motor function and CP. Conclusions Severe EUGR among EPT infants was associated with decreased IQ at 5 years of age.

Dados da publicação

ISSN/ISSNe:: 1359-2998, 1468-2052
Tipo:: Article
Páginas:: 492-498
DOI:: 10.1136/archdischild-2022-324988

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El Rafei, R:: Univ Paris Cite, Ctr Res Epidemiol & Stat CRESS, INRAE, Obstet Perinatal & Pediat Epidemiol Res Team,EPOP, F-75004 Paris, France

Sorbonne Univ, Coll Doctoral, F-75005 Paris, France
Maier, RF:: Univ Marburg, Philipps Univ Marburg, Univ Hosp, Childrens Hosp, Marburg, Germany
Jarreau, PH:: Univ Paris Cite, Ctr Res Epidemiol & Stat CRESS, INRAE, Obstet Perinatal & Pediat Epidemiol Res Team,EPOP, F-75004 Paris, France
Norman, M:: Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden

Karolinska Univ Hosp, Dept Neonatal Med, Stockholm, Sweden
Barros, H:: Univ Porto, EPI Unit, Inst Publ Hlth, Porto, Portugal

Univ Porto, Sch Med, Dept Clin Epidemiol Predict Med & Publ Hlth, Porto, Portugal
Van Reempts, P:: Univ Antwerp, Ctr Perinatal Epidemiol Flanders, Lab Expt Med & Pediat, Div Neonatol Study, Brussels, Belgium
Van Heijst, A:: Radboud Univ Nijmegen, Med Ctr, Dept Neonatol, Nijmegen, Netherlands

Erasmusmc, Rotterdam, Netherlands
Pedersen, P:: Hvidovre Univ Hosp, Dept Paediat, Hvidovre, Denmark
Cuttini, M:: Bambino Gesu Pediat Hosp, Clin Care & Management Innovat Res Area, Rome, Italy
Johnson, S:: Univ Leicester, Dept Hlth Sci, Leicester, Leics, England
Zemlin, M:: Univ Saarland, Sch Med, Dept Gen Paediat & Neonatol, Homburg, Germany
Draper, ES:: Univ Leicester, Dept Hlth Sci, Leicester, Leics, England
Zeitlin, J:: Univ Paris Cite, Ctr Res Epidemiol & Stat CRESS, INRAE, Obstet Perinatal & Pediat Epidemiol Res Team,EPOP, F-75004 Paris, France