Weight, Length, and Head Circumference Z-scores at 36 Weeks Are Not Accurate in Predicting Neurodevelopmental Impairment in Preterm Infants Less Than 30 Weeks Gestation (P11-062-19).

Abstract

Objectives\nThe association between poor growth and neurodevelopmental impairment (NDI) among preterm infants is well-established whether due to inadequate nutrition, adverse events or both. The present study assessed the diagnostic accuracy of 36-week anthropometric measures, including corresponding\xa0<\xa010th and\xa0<\xa03rd percentile cut points to predict NDI in preterm infants.\n\n\nMethods\nThis study included data from the PreM Growth Cohort Study for preterm infants\xa0<\xa030 weeks of gestational age (GA) and birth weights\xa0<\xa01500 grams. The accuracy with which measured weight, length and head circumference z-scores can predict cognitive impairment (Bayley-III Cognitive Composite score\xa0<\xa080) at 21 months corrected age (born in 2005-2014) and intellectual impairment (Wechsler Preschool and Primary Scale of Intelligence-3rd and 4th Edition (Intellectual test) score\xa0<\xa070) at 3-years corrected age (born in 2001-2014) was determined by the area under the receiver operating characteristic curve (AUROC).\n\n\nResults\nAt 21 months 98/621 (15.8%) of infants had low Bayley scores and 57/613 (9.3%) had low Intellectual test scores at 3 years. None of the AUROCs exceeded 0.6 and none were significantly different from 0.5. Sensitivities and specificities for the 10th and 3rd percentile cut points were equally poor, with most not exceeding 70% (Figures). The findings were similar between the Fenton 2013 and INTERGROWTH 2015 growth charts. The addition of morbidities increased the accuracy of predicting cognitive impairments except for infants with cerebral palsy, other morbidities had relatively marginal associations with impairment.\n\n\nConclusions\nPreterm infant measures of weight, length, and head circumference z-scores at 36 weeks, including corresponding\xa0<\xa010th and\xa0<\xa03rd percentile cut points, are not accurate as predictors of NDI. This study confirms previous findings that preterm infants show some catch up in weight relative to growth references between 37-44 weeks GA. ClinicalTrials.gov Identifier: NCT03064022.\n\n\nFunding Sources\nCanadian Foundation for Dietetic Research.\n\n\nSupporting Tables Images and/or Graphs