Early body composition changes are associated with neurodevelopmental and metabolic outcomes at 4 years of age in very preterm infants

• Published in: Pediatric research Vol. 84; no. 5; pp. 713 - 718
• Main Authors: Pfister, Katie M., Zhang, Lei, Miller, Neely C., Ingolfsland, Ellen C., Demerath, Ellen W., Ramel, Sara E.
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.11.2018; Nature Publishing Group
• Subjects: Anthropometry; Blood Pressure; Body composition; Body Composition - physiology; Central Nervous System - growth & development; Child, Preschool; Clinical Research Article; Evoked Potentials, Visual; Female; Humans; Infant, Extremely Premature - metabolism; Infant, Extremely Premature - physiology; Male; Medicine; Medicine & Public Health; Metabolism; Pediatric Surgery; Pediatrics; Premature babies; Prospective Studies
• ISSN: 0031-3998; 1530-0447; 1530-0447
• DOI: 10.1038/s41390-018-0158-x

Background Very preterm (VPT) infants are at-risk for altered growth, slower speed of processing (SOP), and hypertension. This study assesses the relationship between postnatal body composition (BC), neurodevelopment (indexed by SOP), and blood pressure (BP) in VPT infants. Methods Thirty-four VPT infants underwent weekly measurements and BC testing until discharge and post-discharge at 4 mos CGA and 4 yrs. At post-discharge visits, SOP was assessed using visual evoked potentials and the NIH Toolbox; BP was also measured. Results In-hospital rate of weight, length and fat-free mass (FFM) gains were associated with faster SOP at 4 yrs. Higher rate of gains in weight and FFM from discharge to 4 mos CGA were associated with faster SOP at 4 mos CGA, while higher fat mass (FM) gains during the same time were positively associated with BP at 4 yrs. BC at 4 yrs nor gains beyond 4 mos CGA were associated with outcomes. Conclusions In VPT infants, early FFM gains are associated with faster SOP, whereas post-discharge FM gains are associated with higher BPs at 4 yrs. This shows birth to 4 mos CGA is a sensitive period for growth and its relation to neurodevelopmental and metabolic outcomes. Close monitoring and early nutritional adjustments to optimize quality of gains may improve outcomes.