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Growth and development in children born very low birthweight
  1. Rebecca J Scharf1,
  2. Annemarie Stroustrup2,
  3. Mark R Conaway3,
  4. Mark D DeBoer4
  1. 1Division of Developmental Pediatrics, Department of Pediatrics, University of Virginia, Charlottesville, Virginia, USA
  2. 2Division of Newborn Medicine, Department of Pediatrics and Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
  3. 3Department of Public Health, University of Virginia, Charlottesville, Virginia, USA
  4. 4Division of Pediatric Endocrinology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia, USA
  1. Correspondence to Dr Rebecca J Scharf, Division of Developmental Pediatrics, University of Virginia School of Medicine, P.O. Box 800828, Charlottesville, Virginia 22908, USA; rs3yk{at}virginia.edu

Abstract

Objective To examine the relationships between growth (birth to age 2 years) and developmental outcomes in children born with very low birthweight (VLBW).

Design Motor and mental development in children born with VLBW were regressed on anthropometric measurements at birth, 9 months and 2 years using multivariable regression.

Setting The Early Childhood Longitudinal Study—Birth Cohort, a longitudinal cohort, community sample, designed to be representative of children born across the USA.

Patients 950 children born with VLBW (<1500 g).

Main Outcome Measures Motor and cognitive scores on the Bayley Scales at 9 months and 24 months chronological age.

Results A high proportion of children exhibited poor growth, with length-for-age z-scores <−2 (ie, stunting) in 21.3% of children at 9 months (adjusted for prematurity) and 34.2% of children at 2 years. Compared with children having z-scores >−2, children with growth shortfalls in head circumference, length and weight had a higher adjusted OR (aOR) of low Bayley motor scores at 9 months and 2 years (aOR ranging from 1.8 to 3.3, all p<0.05), while low Bayley cognitive scores were predicted by 9-month deficits in length and weight (aOR 2.0 and 2.4, respectively, both p<0.01) and 2-year deficits in length and head circumference (aOR 2.9 and 2.8, both p<0.05).

Conclusion Anthropometric measures of growth were linked to current and future neurodevelopmental outcomes in children born with VLBW. While careful length measures may be a particularly useful marker, deficits in all anthropometric measures were risk factors for developmental delays.

  • Growth
  • Neurodevelopment

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