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

Rym El Rafei; Rolf Felix Maier; Pierre Henri Jarreau; Mikael Norman; Henrique Barros; Patrick Van Reempts; Arno Van Heijst; Pernille Pedersen; Marina Cuttini; Samantha Johnson; Raquel Costa; Michael Zemlin; Elizabeth S. Draper; Jennifer Zeitlin

doi:10.1136/archdischild-2022-324988

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

Rym El Rafei^*, Rolf Felix Maier, Pierre Henri Jarreau, Mikael Norman, Henrique Barros, Patrick Van Reempts, Arno Van Heijst, Pernille Pedersen, Marina Cuttini, Samantha Johnson, Raquel Costa, Michael Zemlin, Elizabeth S. Draper, Jennifer Zeitlin

^*Corresponding author af dette arbejde

Børne- og Ungeafdelingen

12 Citationer (Scopus)

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.

Originalsprog	Engelsk
Artikelnummer	archdischild-2022-324988
Tidsskrift	Archives of Disease in Childhood: Fetal and Neonatal Edition
Vol/bind	108
Udgave nummer	5
Sider (fra-til)	492-498
Antal sider	7
ISSN	1359-2998
DOI	https://doi.org/10.1136/archdischild-2022-324988
Status	Udgivet - sep. 2023

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10.1136/archdischild-2022-324988

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El Rafei, R., Maier, R. F., Jarreau, P. H., Norman, M., Barros, H., Van Reempts, P., Van Heijst, A., Pedersen, P., Cuttini, M., Johnson, S., Costa, R., Zemlin, M., Draper, E. S., & Zeitlin, J. (2023). Postnatal growth restriction and neurodevelopment at 5 years of age: A European extremely preterm birth cohort study. Archives of Disease in Childhood: Fetal and Neonatal Edition, 108(5), 492-498. Artikel archdischild-2022-324988. https://doi.org/10.1136/archdischild-2022-324988

Postnatal growth restriction and neurodevelopment at 5 years of age: A European extremely preterm birth cohort study. / El Rafei, Rym; Maier, Rolf Felix; Jarreau, Pierre Henri et al.
I: Archives of Disease in Childhood: Fetal and Neonatal Edition, Bind 108, Nr. 5, archdischild-2022-324988, 09.2023, s. 492-498.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

El Rafei, R, Maier, RF, Jarreau, PH, Norman, M, Barros, H, Van Reempts, P, Van Heijst, A, Pedersen, P, Cuttini, M, Johnson, S, Costa, R, Zemlin, M, Draper, ES & Zeitlin, J 2023, 'Postnatal growth restriction and neurodevelopment at 5 years of age: A European extremely preterm birth cohort study', Archives of Disease in Childhood: Fetal and Neonatal Edition, bind 108, nr. 5, archdischild-2022-324988, s. 492-498. https://doi.org/10.1136/archdischild-2022-324988

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title = "Postnatal growth restriction and neurodevelopment at 5 years of age: A European extremely preterm birth cohort study",

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.",

keywords = "Cerebral Palsy, Child, Child Development, Child, Preschool, Cognition Disorders, Cohort Studies, Europe, Female, Humans, Infant, Infant, Extremely Premature, Infant, Newborn, Male, Neurodevelopmental Disorders, Pregnancy",

author = "{El Rafei}, Rym and Maier, {Rolf Felix} and Jarreau, {Pierre Henri} and Mikael Norman and Henrique Barros and {Van Reempts}, Patrick and {Van Heijst}, Arno and Pernille Pedersen and Marina Cuttini and Samantha Johnson and Raquel Costa and Michael Zemlin and Draper, {Elizabeth S.} and Jennifer Zeitlin",

note = "Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2023",

month = sep,

doi = "10.1136/archdischild-2022-324988",

language = "English",

volume = "108",

pages = "492--498",

journal = "Archives of Disease in Childhood: Fetal and Neonatal Edition",

issn = "1359-2998",

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T1 - Postnatal growth restriction and neurodevelopment at 5 years of age

T2 - A European extremely preterm birth cohort study

AU - El Rafei, Rym

AU - Maier, Rolf Felix

AU - Jarreau, Pierre Henri

AU - Norman, Mikael

AU - Barros, Henrique

AU - Van Reempts, Patrick

AU - Van Heijst, Arno

AU - Pedersen, Pernille

AU - Cuttini, Marina

AU - Johnson, Samantha

AU - Costa, Raquel

AU - Zemlin, Michael

AU - Draper, Elizabeth S.

AU - Zeitlin, Jennifer

N1 - Publisher Copyright: © Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2023/9

Y1 - 2023/9

N2 - 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.

AB - 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.

KW - Cerebral Palsy

KW - Child

KW - Child Development

KW - Child, Preschool

KW - Cognition Disorders

KW - Cohort Studies

KW - Europe

KW - Female

KW - Humans

KW - Infant

KW - Infant, Extremely Premature

KW - Infant, Newborn

KW - Male

KW - Neurodevelopmental Disorders

KW - Pregnancy

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U2 - 10.1136/archdischild-2022-324988

DO - 10.1136/archdischild-2022-324988

M3 - Journal article

C2 - 36868809

AN - SCOPUS:85152200831

SN - 1359-2998

VL - 108

SP - 492

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JO - Archives of Disease in Childhood: Fetal and Neonatal Edition

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

Abstract

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