Postnatal growth in VLBW infants: significant association with neurodevelopmental outcome

J Pediatr. 2003 Aug;143(2):163-70. doi: 10.1067/S0022-3476(03)00243-9.


Objective: To study the significance of growth status at birth and postnatal growth on neurodevelopmental outcome in very low birth weight (VLBW) infants.

Study design: Growth and neurodevelopment were examined in 219 VLBW (<1250 g) children, 94 small for gestational age (SGA) (<10th percentile) and 125 appropriate for gestational age (AGA) (>10th percentile). Outcome at age 2 was assessed with the Bayley Scales of Infant Development (Mental Developmental Index [MDI], Psychomotor Developmental Index [PDI]) and a standardized neurologic examination.

Results: SGA status was not associated with poor neurodevelopmental outcome. However, after adjustment for covariables including cerebral palsy (CP), SGA children with weight <10th percentile at age 2 had lower mean PDI than SGA children with catch-up growth to weight >10th percentile (mean [SD], 89.9 [17.4] versus 101.8 [14.5]; P<.001). AGA children with catch-down growth (weight <10th percentile at age 2) were, independent of CP, more likely to have lower mean MDI (94.9 vs 101.7, P=.05) and PDI (81.9 vs 95.1; P<.001) than AGA children remaining >10th percentile at age 2. They also more frequently had severe CP (22.9% vs 1.2%; P=.008).

Conclusions: In VLBW children, the course of postnatal growth rather than the appropriateness of weight for gestational age at birth determines later neurodevelopmental outcome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Weight
  • Child Development / physiology*
  • Child, Preschool
  • Female
  • Gestational Age
  • Humans
  • Infant
  • Infant, Newborn / growth & development
  • Infant, Premature / growth & development*
  • Infant, Small for Gestational Age / growth & development
  • Infant, Very Low Birth Weight / growth & development*
  • Male
  • Psychomotor Performance / physiology