Document Detail


Growth in the neonatal intensive care unit influences neurodevelopmental and growth outcomes of extremely low birth weight infants.
MedLine Citation:
PMID:  16585322     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The objectives of this study were to assess whether (1) in-hospital growth velocity is predictive of neurodevelopmental and growth outcomes at 18 to 22 months' corrected age among extremely low birth weight (ELBW) infants and (2) in-hospital growth velocity contributes to these outcomes after controlling for confounding demographic and clinical variables. METHODS: Infants 501 to 1000 g birth weight from a multicenter cohort study were divided into quartiles of in-hospital growth velocity rates. Variables considered for the logistic-regression models included gender, race, gestational age, small for gestational age, mother's education, severe intraventricular hemorrhage, periventricular leukomalacia, age at regaining birth weight, necrotizing enterocolitis, late-onset infection, bronchopulmonary dysplasia, postnatal steroid therapy for pulmonary disease, and center. RESULTS: Of the 600 discharged infants, 495 (83%) were evaluated at 18 to 22 months' corrected age. As the rate of weight gain increased between quartile 1 and quartile 4, from 12.0 to 21.2 g/kg per day, the incidence of cerebral palsy, Bayley II Mental Developmental Index (MDI) <70 and Psychomotor Developmental Index (PDI) <70, abnormal neurologic examination, neurodevelopmental impairment, and need for rehospitalization fell significantly. Similar findings were observed as the rate of head circumference growth increased. The in-hospital rate of growth was associated with the likelihood of anthropometric measurements at 18 months' corrected age below the 10th percentile values of the Centers for Disease Control and Prevention 2000 growth curve. Logistic-regression analyses, controlling for potential demographic or clinical cofounders, and adjusted for center, identified a significant relationship between growth velocity and the likelihood of cerebral palsy, MDI and PDI scores of <70, and neurodevelopmental impairment. CONCLUSIONS: These analyses suggest that growth velocity during an ELBW infant's NICU hospitalization exerts a significant, and possibly independent, effect on neurodevelopmental and growth outcomes at 18 to 22 months' corrected age.
Authors:
Richard A Ehrenkranz; Anna M Dusick; Betty R Vohr; Linda L Wright; Lisa A Wrage; W Kenneth Poole
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Pediatrics     Volume:  117     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-04-04     Completed Date:  2006-05-10     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1253-61     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06520-8064, USA. richard.ehrenkranz@yale.edu
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MeSH Terms
Descriptor/Qualifier:
Body Height
Body Weight
Cephalometry
Child Development*
Developmental Disabilities / etiology*
Female
Humans
Infant
Infant, Newborn
Infant, Very Low Birth Weight / growth & development*
Intensive Care Units, Neonatal
Male
Neurologic Examination
Weight Gain
Grant Support
ID/Acronym/Agency:
M01 RR 00070/RR/NCRR NIH HHS; M01 RR 00750/RR/NCRR NIH HHS; M01 RR 00997/RR/NCRR NIH HHS; M01 RR 01032/RR/NCRR NIH HHS; M01 RR 02172/RR/NCRR NIH HHS; M01 RR 02635/RR/NCRR NIH HHS; M01 RR 06022/RR/NCRR NIH HHS; M01 RR 08084/RR/NCRR NIH HHS; U01 HD36790/HD/NICHD NIH HHS; U10 HD21364/HD/NICHD NIH HHS; U10 HD21373/HD/NICHD NIH HHS; U10 HD21385/HD/NICHD NIH HHS; U10 HD21397/HD/NICHD NIH HHS; U10 HD21415/HD/NICHD NIH HHS; U10 HD27851/HD/NICHD NIH HHS; U10 HD27853/HD/NICHD NIH HHS; U10 HD27856/HD/NICHD NIH HHS; U10 HD27871/HD/NICHD NIH HHS; U10 HD27880/HD/NICHD NIH HHS; U10 HD27881/HD/NICHD NIH HHS; U10 HD27904/HD/NICHD NIH HHS; U10 HD34167/HD/NICHD NIH HHS; U10 HD34216/HD/NICHD NIH HHS

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