Comparative impact of early versus late growth on neurodevelopment in neonates.

BACKGROUND

Adverse neurodevelopmental outcomes are linked to preterm birth. Although survival rates have improved due to advancements in newborn care, long-term developmental outcomes continue to be a concern.

METHODS

This retrospective study examines the relationship between anthropometric measures, including weight, head circumference (HC) and length z-scores, at birth, discharge and follow-up and motor and cognitive development, using data from 562 preterm infants who were monitored for at least 1 year after discharge. Neurodevelopmental outcomes were measured using the Alberta Infant Motor Scale (AIMS) and the Developmental Assessment Scale for Indian Infants.

RESULTS

Higher discharge z-scores for weight, length and HC were significantly associated with improved AIMS scores at 3 months of corrected age, with weight (β=0.94, 95% CI 0.40 to 1.50, p<0.001), length (β=0.67, 95% CI 0.19 to 1.1, p=0.006) and HC (β=0.77, 95% CI 0.19 to 1.4, p=0.010) all showing strong positive associations. Similarly, higher discharge z-scores for these parameters remained associated with better AIMS scores at 6 months and 12 months. Catch-up growth observed at these time points did not influence the outcome (p>0.05).

CONCLUSION

The results of our study lead us to conclude that growth during the neonatal intensive care unit (NICU) stay is more important than post-discharge catch-up growth. This highlights the crucial role of early nutritional and growth support in shaping later motor development. This suggests that the care and nutrition provided during the NICU period have lasting effects on developmental trajectories. Ensuring optimal growth before discharge should therefore be a key focus of neonatal care to improve long-term neurodevelopmental outcomes.