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Title Obesity and neurodevelopmental outcome in very low birth weight infants according to growth velocity in hospital or after discharge
Author 박성희, 박지숙
작성자 박지숙
Background Postnatal growth faltering in preterm infants is largely associated with acute neonatal illnesses and nutritional risks. Improved nutritional support have led to adequate growth and have been associated with improved long-term neurodevelopmental outcomes. However, early postnatal rapid growth in preterm infants may raise concern of later development of the metabolic syndrome.
Aim / Hypothesis We aim to investigate the rate of catch-up growth in VLBW infants affecting the balance between neurodevelopmental and metabolic outcomes of 2 ~3 years after birth. We hypothesize that VLBW infants with rapid catch-up growth rate would lead to obesity in early infancy, but better performance of neurodevelopment.
Inclusion Criteria Very low birth weight infants registered in the Korean Neonatal Network database (2013-2024)
Exclusion Criteria Exclusion: 1) Died in 1 year after birth, 2) with major congenital anomaly, 3) without follow-up data
Study Design Statistical methods 1. Descriptive statistics of demographic characteristics of included VLBW infants 2. Calculate growth velocity from birth to discharge, 18-24 months corrected age and/or 3 years of age. 3. Calculate Z scores of growth parameters (height, weight, and head circumference) at discharge (corrected age) 4. Calculate Z scores of growth parameters and BMI at 18-24 months corrected age and/or 3 years of age 5. Evaluate percentile of Z score and BMI using Fenton growth chart (3. Discharge) and 2017 Korean National Growth Charts for Children and Adolescents of the Korea Disease Control and Prevention Agency (4. Z scores and BMI). 6. Logistic regression analyses for growth velocity and outcomes of growth and neurodevelopmental factors adjusted with risk factors such as GA, BW, or neonatal severe illnesses 7. Generalized linear mixed model for growth velocity and growth or neurodevelopmental outcomes adjusting time (duration) factor 8. Stratified analysis according to SGA might be performed.
Primary Outcomes 1. Z scores and percentiles of height, weight, head circumference at discharge using corrected age 2. Medication including AED, chronic illness including BPD, pul. HTN, etc.
Secondary Outcomes and Definitions 1. Z scores and percentiles of height, weight, head circumference at 18-24 months corrected age and 3 years of age. 2. BMI, Z score and percentile of BMI at 18-24 months corrected age and 3 years of age 3. Cerebral palsy, Bayley scales (BSID-II score <70, BSID-III composite score <85) at 18-24 months corrected age and 3 years of age
Protocols Following the study design described above
Funding No

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