A longer body length and larger head circumference at term significantly influences a better subsequent psychomotor development in very-low-birth-weight infants

The predictive role of early head growth for subsequent outcome was evaluated in 85 infants with birth weight <1,500 g. On the basis of head circumference at birth and head growth between birth and age 6 weeks, infants were divided into four groups: (1) microcephalic at birth with less (< 3.5 cm) postnatal head growth (n = 9), (2) microcephalic at birth with more (≥3.5 cm) postnatal head growth (n = 12), (3) normocephalic at birth with less head growth (n = 32), and (4) normocephalic at birth with more head growth (n = 32). At both 6 and 15 months of age the two groups of infants with less postnatal head growth had an increased incidence of growth failure, whereas the two groups with more postnatal head growth had a low incidence, similar to that for a matched full-term group (n = 95). Major neurologic defects occurred significantly more frequently among infants who were microcephalic with less postnatal head growth; two thirds showed evidence of blindness, hydrocephalus, or spastic diplegia. This group also performed more poorly on the Bayley Scales than any of the other groups. Infants who were normocephalic with greater head growth were free of neurologic defects and had Bayley scores that did not differ from those for the healthy full-term infants. The two groups of infants with only one poor measure of head growth demonstrated intermediate scores at age 6 months. At age 15 months, the group with normocephaly and less postnatal head growth continued to have intermediate scores. The group with microcephaly and greater postnatal head growth, however, showed developmental catch-up; their scores did not differ from those of the group that was normocephalic with greater head growth or the full-term group. Less postnatal head growth was associated with an increased requirement for mechanical ventilation, patent ductus arteriosus, sepsis, delayed tolerance of feeding, and slower weight gain. These data suggest that early postnatal head growth may summarize the adverse effects of many perinatal risk factors and that head circumference at birth and head growth by six weeks are strong predictors of early developmental outcome in very low-birth-weight infants.

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Very Low Birth Weight Infants: Effects of Brain Growth During Infancy on Intelligence Quotient at 3 Years of Age

PEDIATRICS ◽

10.1542/peds.77.2.196 ◽

1986 ◽

Vol 77 (2) ◽

pp. 196-202 ◽

Cited By ~ 3

Author(s):

Maureen Hack ◽

Naomi Breslau

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Head Circumference ◽

Very Low Birth Weight ◽

Postnatal Growth ◽

Brain Growth ◽

Low Birth Weight Infants ◽

Neurologic Impairment ◽

Appropriate For Gestational Age

To evaluate the role of postnatal growth on IQ at 3 years of age, 139 appropriate for gestational age, very low birth weight infants (<1.5 kg) born in 1977 and 1978 were studied at 40 weeks (term), and at 8, 20, and 33 months (corrected) of age. Weight, height, and head circumference were measured at each age, neurologic status was measured at 20 months, and Stanford Binet IQ at 33 months. Multiple regression analysis revealed that head circumference at 8 months of age is the best growth predictor of IQ at 3 years of age. Path analysis was performed to measure the effects of biologic and social factors measured earlier in life on IQ at 3 years. These factors explained 43% of the variance in IQ at 3 years of age. Head circumference at 8 months had a direct effect on IQ at 3 years, controlling for all other variables in the model. Neonatal risk had an indirect effect via head circumference. Neurologic impairment had direct and indirect (via head circumference) effects; race and socioeconomic status had direct effects on IQ but no effects on growth at 8 months of age. Thus, brain growth at 8 months significantly influenced 3 year IQ at 3 years of age among very low birth weight infants, even when medical and sociodemographic variables were controlled.

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Effect of early introduction of minimal enteral feeding on growth and rate of achieving optimal nutritive intake in very low birth weight preterm infants

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh160205024m ◽

2017 ◽

Vol 145 (7-8) ◽

pp. 336-339

Author(s):

Vesna Marinkovic ◽

Niveska Bozinovic-Prekajski ◽

Milica Rankovic-Janevski ◽

Zorica Jelic ◽

Vesna Hajdarpasic ◽

...

Keyword(s):

Body Weight ◽

Weight Gain ◽

Birth Weight ◽

Low Birth Weight ◽

Preterm Infants ◽

Body Length ◽

Head Circumference ◽

Very Low Birth Weight ◽

Body Weight Gain ◽

Early Introduction

Introduction/Objective. Minimal enteral nutrition (MEN) has an important stimulative effect on morphological and functional development of gastrointestinal system in preterm infants. The aim of this study was to assess effects of early introduced MEN on rate of achieving optimal enteral nutritive intake and on body weight, body length, and head circumference gain in very low birth weight (VLBW) premature infants. Methods. This prospective study included 45 VLBW newborns (1,010?1,450; 1,350 ? 305 g), in 30 newborns MEN was introduced within three days after birth, and in 15 newborns enteral intake was introduced after five days due to hemodynamic and metabolic instability. Assessment of effect of early MEN introduction on the rate of achieving optimal nutritive intake and gain in basic anthropometric parameters was based on comparison with a group of subjects who had a delayed MEN introduction. Results. Subjects in which MEN was introduced early on had better weight gain (p < 0.05), reached birth weight sooner (p < 0.05), and achieved optimal enteral intake much sooner (p < 0.05), compared to subjects with delayed MEN introduction. The difference in body length gain and head circumference gain was not significant. Conclusion. Early introduction of MEN has a significant positive effect on rate of body weight gain and on earlier achievement of optimal enteral intake in VLBW preterm infants.

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