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Association between postnatal growth and neurodevelopmental impairment by sex at 2 years of corrected age in a multi-national cohort of very preterm children

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@article{2474429da66342dbaeb1cd95ad6f24a7,
title = "Association between postnatal growth and neurodevelopmental impairment by sex at 2 years of corrected age in a multi-national cohort of very preterm children",
abstract = "BACKGROUND & AIMS: Extra-uterine growth restriction (EUGR) is common among very preterm (VPT) infants and has been associated with impaired neurodevelopment. Some research suggests that adverse effects of EUGR may be more severe in boys. We investigated EUGR and neurodevelopment at 2 years of corrected age (CA) by sex in a VPT birth cohort.METHODS: Data come from a population-based cohort of children born <32 weeks' gestation from 11 European countries and followed up at 2 years CA. Postnatal growth during the neonatal hospitalization was measured with: (1) birthweight and discharge-weight Z-score differences using Fenton charts (2) weight-gain velocity using Patel's model. Published cut-offs were used to define EUGR as none, moderate or severe. Neurodevelopmental impairment was assessed using a parent-report questionnaire, with standardized questions/instruments on motor function, vision, hearing and non-verbal cognition. We estimated relative risks (RR) adjusting for maternal and neonatal characteristics overall and by sex.RESULTS: Among 4197 infants, the prevalence of moderate to severe impairment at 2 years CA was 17.7%. Severe EUGR was associated with neurodevelopmental impairment in the overall sample and the interaction with sex was significant. For boys, adjusted RR were 1.57 (95% Confidence Intervals (CI): 1.18-2.09) for Fenton's delta Z-score and 1.50 (95% CI: 1.12-2.01) for Patel's weight-gain velocity, while for girls they were 0.97 (0.76-1.22) and 1.12 (0.90-1.40) respectively.CONCLUSION: EUGR was associated with poor neurodevelopment at 2 years among VPT boys but not girls. Understanding why boys are more susceptible to the effects of poor growth is needed to develop appropriate healthcare strategies.",
keywords = "Extrauterine growth restriction, Neurodevelopmental impairment, Suboptimal growth, Very preterm infants",
author = "{El Rafei}, Rym and Jarreau, {Pierre Henri} and Mikael Norman and Maier, {Rolf Felix} and Henrique Barros and {Van Reempts}, Patrick and Pernille Pedersen and Marina Cuttini and Raquel Costa and Michael Zemlin and Draper, {Elizabeth S} and Jennifer Zeitlin and {EPICE Research Group}",
note = "Copyright {\textcopyright} 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.",
year = "2021",
month = aug,
day = "1",
doi = "10.1016/j.clnu.2021.07.005",
language = "English",
volume = "40",
pages = "4948--4955",
journal = "Clinical Nutrition",
issn = "0261-5614",
publisher = "Elsevier BV",
number = "8",

}

RIS

TY - JOUR

T1 - Association between postnatal growth and neurodevelopmental impairment by sex at 2 years of corrected age in a multi-national cohort of very preterm children

AU - El Rafei, Rym

AU - Jarreau, Pierre Henri

AU - Norman, Mikael

AU - Maier, Rolf Felix

AU - Barros, Henrique

AU - Van Reempts, Patrick

AU - Pedersen, Pernille

AU - Cuttini, Marina

AU - Costa, Raquel

AU - Zemlin, Michael

AU - Draper, Elizabeth S

AU - Zeitlin, Jennifer

AU - EPICE Research Group

N1 - Copyright © 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

PY - 2021/8/1

Y1 - 2021/8/1

N2 - BACKGROUND & AIMS: Extra-uterine growth restriction (EUGR) is common among very preterm (VPT) infants and has been associated with impaired neurodevelopment. Some research suggests that adverse effects of EUGR may be more severe in boys. We investigated EUGR and neurodevelopment at 2 years of corrected age (CA) by sex in a VPT birth cohort.METHODS: Data come from a population-based cohort of children born <32 weeks' gestation from 11 European countries and followed up at 2 years CA. Postnatal growth during the neonatal hospitalization was measured with: (1) birthweight and discharge-weight Z-score differences using Fenton charts (2) weight-gain velocity using Patel's model. Published cut-offs were used to define EUGR as none, moderate or severe. Neurodevelopmental impairment was assessed using a parent-report questionnaire, with standardized questions/instruments on motor function, vision, hearing and non-verbal cognition. We estimated relative risks (RR) adjusting for maternal and neonatal characteristics overall and by sex.RESULTS: Among 4197 infants, the prevalence of moderate to severe impairment at 2 years CA was 17.7%. Severe EUGR was associated with neurodevelopmental impairment in the overall sample and the interaction with sex was significant. For boys, adjusted RR were 1.57 (95% Confidence Intervals (CI): 1.18-2.09) for Fenton's delta Z-score and 1.50 (95% CI: 1.12-2.01) for Patel's weight-gain velocity, while for girls they were 0.97 (0.76-1.22) and 1.12 (0.90-1.40) respectively.CONCLUSION: EUGR was associated with poor neurodevelopment at 2 years among VPT boys but not girls. Understanding why boys are more susceptible to the effects of poor growth is needed to develop appropriate healthcare strategies.

AB - BACKGROUND & AIMS: Extra-uterine growth restriction (EUGR) is common among very preterm (VPT) infants and has been associated with impaired neurodevelopment. Some research suggests that adverse effects of EUGR may be more severe in boys. We investigated EUGR and neurodevelopment at 2 years of corrected age (CA) by sex in a VPT birth cohort.METHODS: Data come from a population-based cohort of children born <32 weeks' gestation from 11 European countries and followed up at 2 years CA. Postnatal growth during the neonatal hospitalization was measured with: (1) birthweight and discharge-weight Z-score differences using Fenton charts (2) weight-gain velocity using Patel's model. Published cut-offs were used to define EUGR as none, moderate or severe. Neurodevelopmental impairment was assessed using a parent-report questionnaire, with standardized questions/instruments on motor function, vision, hearing and non-verbal cognition. We estimated relative risks (RR) adjusting for maternal and neonatal characteristics overall and by sex.RESULTS: Among 4197 infants, the prevalence of moderate to severe impairment at 2 years CA was 17.7%. Severe EUGR was associated with neurodevelopmental impairment in the overall sample and the interaction with sex was significant. For boys, adjusted RR were 1.57 (95% Confidence Intervals (CI): 1.18-2.09) for Fenton's delta Z-score and 1.50 (95% CI: 1.12-2.01) for Patel's weight-gain velocity, while for girls they were 0.97 (0.76-1.22) and 1.12 (0.90-1.40) respectively.CONCLUSION: EUGR was associated with poor neurodevelopment at 2 years among VPT boys but not girls. Understanding why boys are more susceptible to the effects of poor growth is needed to develop appropriate healthcare strategies.

KW - Extrauterine growth restriction

KW - Neurodevelopmental impairment

KW - Suboptimal growth

KW - Very preterm infants

UR - http://www.scopus.com/inward/record.url?scp=85111716641&partnerID=8YFLogxK

U2 - 10.1016/j.clnu.2021.07.005

DO - 10.1016/j.clnu.2021.07.005

M3 - Journal article

C2 - 34358841

VL - 40

SP - 4948

EP - 4955

JO - Clinical Nutrition

JF - Clinical Nutrition

SN - 0261-5614

IS - 8

ER -

ID: 67244252