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Weight Growth Velocity and Neurodevelopmental Outcomes in Extremely Low Birth Weight Infants.

Maruyama H, Yonemoto N, Kono Y, Kusuda S, Fujimura M, Neonatal Research Network of Jap - PLoS ONE (2015)

Bottom Line: With the categorical approach, the adjusted odds ratios for death or NDI with WGV scores of 6 and 7 were 2.41 (95%CI, 1.60-3.62) and 1.81 (95%CI, 1.18-2.75), respectively, relative to the reference WGV score of 10.WGV scores ≥8 did not predict death or NDI.WGV scores <8 were significant predictors suggesting that values of WGV during hospitalization in a NICU are associated with neurodevelopmental outcomes.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Kochi Health Sciences Center, Kochi, Kochi, Japan.

ABSTRACT

Introduction: This study aimed to assess whether weight growth velocity (WGV) predicts neurodevelopmental outcomes in extremely low birth weight infants (ELBWIs).

Methods: Subjects were infants who weighed 501-1000 g at birth and were included in the cohort of the Neonatal Research Network of Japan (2003-2007). Patel's exponential model (EM) method was used to calculate WGV between birth and discharge. Assessment of predictions of death or neurodevelopmental impairment (NDI) was performed at 3 years of age based on the WGV score, which was categorized by per one increase in WGV. Multivariate logistic regression analysis was used to calculate adjusted odds ratios and their 95% confidence intervals (95%CI).

Results: In the 2961 ELBWIs assessed, the median WGV was 10.5 g/kg/day (interquartile, 9.4-11.9). With the categorical approach, the adjusted odds ratios for death or NDI with WGV scores of 6 and 7 were 2.41 (95%CI, 1.60-3.62) and 1.81 (95%CI, 1.18-2.75), respectively, relative to the reference WGV score of 10. WGV scores ≥8 did not predict death or NDI.

Conclusions: WGV scores <8 were significant predictors suggesting that values of WGV during hospitalization in a NICU are associated with neurodevelopmental outcomes. Further investigations is necessary to determine whether additional nutritional support may improve low WGV in ELBWIs.

No MeSH data available.


Related in: MedlinePlus

Histogram of weight growth velocity (WGV) scores.
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pone.0139014.g002: Histogram of weight growth velocity (WGV) scores.

Mentions: In the NRNJ 2003–2007 database, which includes data from 49 centers, there were 3495 eligible infants with BWs between 501 and 1000 g. After excluding 534 cases as shown in Fig 1, we analyzed 2961 cases including 1189 cases that were lost to follow-up. The outcomes of patients we were able to follow included no NDI (1223), NDI (531) and death (18). Of the 1754 NDI and no-NDI cases, 1468 had undergone the KSPD test. NDI cases included 214 cases with cerebral palsy, 38 with visual impairment, 25 with hearing impairment and 350 with developmental delay (294 with DQ <70 and 56 judged by physicians). 89 infants had more than one on these impairments. There were 358 infants with missing WGV data and 113 overlap cases. The missing values of WGV and neurodevelopmental outcomes were imputed by the MI method. Clinical characteristics of the data-imputed infants (n = 1189 + 358–113 = 1434) were early GA, small BW and many morbidities such as RDS, CLD, PDA, NEC and IVH. After MI, there were 18 deaths post-discharge (0.6%) and 533 NDI cases (18.0%) among the eligible cases. Clinical characteristics of the subjects divided into nine groups by WGV scores are shown in Table 1. The WGV score distribution is shown in Fig 2. The mean WGV was 10.6 g/kg/day (SD 2.5), and the median WGV was 10.5 (interquartile, 9.4–11.9; min-max, 0–44.4). The distribution before MI was similar to this result, with the mean (SD) WGV of 10.8 (2.5) g/kg/day (n = 1527). The mean WGV score of the study population was 10. There were some differences in clinical characteristics between infants with the KSPD test and those without. The clinical characteristics of infants without the KSPD test included early GA and some morbidities, such as RDS and NEC.


Weight Growth Velocity and Neurodevelopmental Outcomes in Extremely Low Birth Weight Infants.

Maruyama H, Yonemoto N, Kono Y, Kusuda S, Fujimura M, Neonatal Research Network of Jap - PLoS ONE (2015)

Histogram of weight growth velocity (WGV) scores.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4581837&req=5

pone.0139014.g002: Histogram of weight growth velocity (WGV) scores.
Mentions: In the NRNJ 2003–2007 database, which includes data from 49 centers, there were 3495 eligible infants with BWs between 501 and 1000 g. After excluding 534 cases as shown in Fig 1, we analyzed 2961 cases including 1189 cases that were lost to follow-up. The outcomes of patients we were able to follow included no NDI (1223), NDI (531) and death (18). Of the 1754 NDI and no-NDI cases, 1468 had undergone the KSPD test. NDI cases included 214 cases with cerebral palsy, 38 with visual impairment, 25 with hearing impairment and 350 with developmental delay (294 with DQ <70 and 56 judged by physicians). 89 infants had more than one on these impairments. There were 358 infants with missing WGV data and 113 overlap cases. The missing values of WGV and neurodevelopmental outcomes were imputed by the MI method. Clinical characteristics of the data-imputed infants (n = 1189 + 358–113 = 1434) were early GA, small BW and many morbidities such as RDS, CLD, PDA, NEC and IVH. After MI, there were 18 deaths post-discharge (0.6%) and 533 NDI cases (18.0%) among the eligible cases. Clinical characteristics of the subjects divided into nine groups by WGV scores are shown in Table 1. The WGV score distribution is shown in Fig 2. The mean WGV was 10.6 g/kg/day (SD 2.5), and the median WGV was 10.5 (interquartile, 9.4–11.9; min-max, 0–44.4). The distribution before MI was similar to this result, with the mean (SD) WGV of 10.8 (2.5) g/kg/day (n = 1527). The mean WGV score of the study population was 10. There were some differences in clinical characteristics between infants with the KSPD test and those without. The clinical characteristics of infants without the KSPD test included early GA and some morbidities, such as RDS and NEC.

Bottom Line: With the categorical approach, the adjusted odds ratios for death or NDI with WGV scores of 6 and 7 were 2.41 (95%CI, 1.60-3.62) and 1.81 (95%CI, 1.18-2.75), respectively, relative to the reference WGV score of 10.WGV scores ≥8 did not predict death or NDI.WGV scores <8 were significant predictors suggesting that values of WGV during hospitalization in a NICU are associated with neurodevelopmental outcomes.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Kochi Health Sciences Center, Kochi, Kochi, Japan.

ABSTRACT

Introduction: This study aimed to assess whether weight growth velocity (WGV) predicts neurodevelopmental outcomes in extremely low birth weight infants (ELBWIs).

Methods: Subjects were infants who weighed 501-1000 g at birth and were included in the cohort of the Neonatal Research Network of Japan (2003-2007). Patel's exponential model (EM) method was used to calculate WGV between birth and discharge. Assessment of predictions of death or neurodevelopmental impairment (NDI) was performed at 3 years of age based on the WGV score, which was categorized by per one increase in WGV. Multivariate logistic regression analysis was used to calculate adjusted odds ratios and their 95% confidence intervals (95%CI).

Results: In the 2961 ELBWIs assessed, the median WGV was 10.5 g/kg/day (interquartile, 9.4-11.9). With the categorical approach, the adjusted odds ratios for death or NDI with WGV scores of 6 and 7 were 2.41 (95%CI, 1.60-3.62) and 1.81 (95%CI, 1.18-2.75), respectively, relative to the reference WGV score of 10. WGV scores ≥8 did not predict death or NDI.

Conclusions: WGV scores <8 were significant predictors suggesting that values of WGV during hospitalization in a NICU are associated with neurodevelopmental outcomes. Further investigations is necessary to determine whether additional nutritional support may improve low WGV in ELBWIs.

No MeSH data available.


Related in: MedlinePlus