Does Growth Velocity Affect Associations between Birth Weight and Neurodevelopment for Infants Born Very Preterm?

Autor: Sériès T; School of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Canada., Guillot M; Department of Pediatrics, Faculty of Medicine, Centre Hospitalier Universitaire de Québec-Université Laval, Québec, Canada., Angoa G; Department of Pediatrics, Faculty of Medicine, Centre Hospitalier Universitaire de Québec-Université Laval, Québec, Canada., Pronovost E; Department of Pediatrics, Faculty of Medicine, Centre Hospitalier Universitaire de Québec-Université Laval, Québec, Canada., Ndiaye ABKT; Department of Pediatrics, Faculty of Medicine, Centre Hospitalier Universitaire de Québec-Université Laval, Québec, Canada., Mohamed I; Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Montréal, Canada., Simonyan D; Clinical and Evaluative Research platform, Centre de recherche du Centre Hospitalier Universitaire de Québec-Université Laval, Québec, Canada., Lavoie PM; Division of Neonatology, Department of Pediatrics, University of British Columbia, Vancouver, Canada., Synnes A; Division of Neonatology, Department of Pediatrics, University of British Columbia, Vancouver, Canada., Marc I; Department of Pediatrics, Faculty of Medicine, Centre Hospitalier Universitaire de Québec-Université Laval, Québec, Canada. Electronic address: isabelle.marc@crchudequebec.ulaval.ca.
Jazyk: angličtina
Zdroj: The Journal of pediatrics [J Pediatr] 2023 Sep; Vol. 260, pp. 113531. Date of Electronic Publication: 2023 Jun 01.
DOI: 10.1016/j.jpeds.2023.113531
Abstrakt: Objective: To determine how neonatal growth velocity affects the association between birth weight and neurodevelopmental outcomes in infants born preterm.
Study Design: This study is a secondary analysis of the Maternal Omega-3 Supplementation to Reduce Bronchopulmonary Dysplasia in Very Preterm Infants (MOBYDIck) randomized multicenter trial conducted in breastfed infants born at <29 weeks of gestation, whose mothers were supplemented with docosahexaenoic acid or placebo during the neonatal period. Neurodevelopmental outcomes were assessed at 18-22 months of corrected age using the Bayley-III cognitive and language composite scores. The role of neonatal growth velocity was assessed with causal mediation and linear regression models. Subgroup analyses were stratified by birth weight z-score categories (<25th, ≥25th-≤75th, and >75th percentiles).
Results: Neurodevelopmental outcomes were available for 379 children (mean gestational age, 26.7 ± 1.5 weeks). Growth velocity partially mediated the relationships between birth weight and cognitive (β = -1.1; 95% CI, -2.2 to -0.02; P = .05) and language scores (β = -2.1; 95% CI, -3.3 to -0.8; P = .002). An increase by 1 g/kg/day in growth velocity was associated with an increase by 1.1 point in the cognitive score (95% CI, -0.03 to 2.1; P = .06) and 1.9 point in the language score (95% CI, 0.7 to 3.1; P = .001), after adjustment for birth weight z-score. For children with birth weight <25th percentile, a 1 g/kg/day increase in growth velocity was associated with an increase by 3.3 points in the cognitive score (95% CI, 0.5 to 6.0; P = .02) and 4.1 points in the language score (95% CI, 1.3 to 7.0; P = .004).
Conclusions: Postnatal growth velocity mediated the relationship between birth weight and neurodevelopmental performance, with larger effects for children with lower birth weight.
Trial Registration: Clinicaltrials.gov identifier: NCT02371460.
Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest relevant to this article to disclose. The funder/sponsor was not involved in (1) the study design, (2) the collection, analysis, and interpretation of data, (3) the writing of the report, or (4) the decision to submit the manuscript for publication. The MOBYDIck trial was supported by the Canadian Institutes of Health Research (grant MOP-136964 to P.M.L. and Is.M.), by the Fondation du CHU de Québec (grant 2598 to Is.M.) and by the Fonds d’approche Intégrée en Santé des Femmes of the Université Laval (no grant number to Is.M.). M.G. is supported by a research award from CHU de Québec-Université Laval. Is.M. was the recipient of a senior clinician research fellowship (No. 32933) from the Fonds de la Recherche en Santé du Québec. P.M.L. was the recipient of investigator awards from the BC Children's Hospital Research Institute and the Michael Smith Foundation for Health Research.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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