Original ArticleEffect of Intra- and Extrauterine Growth on Long-Term Neurologic Outcomes of Very Preterm Infants
Section snippets
Methods
The EPIPAGE (Étude Épidémiologique sur les Petits Âges Gestationnels [Epidemiological Study on Small Gestational Ages]) 1 is a population-based cohort study recording all live births in 1997 between 22 and 32 weeks' gestation across all maternity units in 9 regions in France (Figure; available at www.jpeds.com). Infants were followed from birth to 8 years of age. Infants with neonatal malformations (n = 426) were excluded. Among the 2242 infants born between 24 and 32 weeks' gestation who were
Results
At 6 months, compared with children with known information on postnatal growth (n = 1489), those without this information (n = 568) more frequently had mothers with non-French nationality (P < .01), received antenatal corticosteroids (78.7% vs 73.3%, P = .013), had a greater mean BW (1412 ± 417.3 vs 1366 ± 382 g, P = .017), and were less frequently breastfed (18.5% vs 23.9%, P < .011) (Table II). Concerning long-term outcome, children with unknown information had significantly more cognitive
Discussion
Our study found differences in the impact of postnatal growth on neurodevelopmental outcomes for SGA and AGA preterm children. For AGA preterm children, growth failure was significantly associated with cerebral palsy. For SGA children, poor postnatal growth was associated with cognitive deficiency and school difficulties, although not significantly. Nevertheless, SGA children remained at risk of cognitive deficiency and behavioral difficulties as compared with children with AGA-FTC.
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Supported by INSERM (National Institute of Health and Medical Research, the Directorate General for Health at the Ministry for Social Affairs, Merck-Sharp and Dohme-Chibret, Medical Research Foundation, and the Hospital Program for Clinical Research (2001 nuAOM01117 of the French Department of Health). The 8-year follow up was supported by the Hospital Program for Clinical Research (2004/054/HP) at the French Department of Health and the Wyeth Foundation for Children and Adolescents. The authors declare no conflicts of interest.
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List of additional members of the EPIPAGE Study Group is available at www.jpeds.com (Appendix).