The association between restricted intra-uterine growth and inadequate postnatal nutrition in very-low-birth-weight infants and their neurodevelopmental outcomes: a 50-month follow-up study

Inadequate nutrition during a critical period of development - as is the case during gestation and the first days of life, especially in very-low-birth-weight (VLBW) infants, can impact on neurodevelopment and favour co-morbidities. In this study, we evaluate how neurodevelopment may be affected by intra-uterine growth (IUGR) restriction and by an inadequate intake of nutritional energy during the early neonatal period. A longitudinal cohort study was conducted to analyse the nutritional contributions received during the first week of life, among a population of 396 VLBW infants. Motor, cognitive, sensory and behavioural development was assessed at 14, 25, 33 and 50 months. The association between IUGR, postnatal energy restriction and neurodevelopment was examined using multivariate logistic regression techniques. Mild cognitive delay was observed in 35 center dot 6 % of neonates with IUGR and in 24 % of those with appropriate birth weight. IUGR is associated with behavioural disorder (OR 2 center dot 60; 95 % CI 1 center dot 25, 5 center dot 40) and delayed cognitive development (OR 2 center dot 64; 95 % CI 1 center dot 34, 5 center dot 20). Energy restriction during the first week of life is associated with visual deficiency (OR 2 center dot 96; 95 % CI 1 center dot 26, 6 center dot 84) and cerebral palsy (OR 3 center dot 05; CI 95 % 1 center dot 00, 9 center dot 54). In VLBW infants, IUGR is associated with behavioural disorder, while postnatal energy restriction is significantly associated with motor disorder, infantile cerebral palsy and sensory disorder.

Automated summary

Insufficient nutrition during the critical periods of gestation and early neonatal life can impact neurodevelopment in VLBW infants. This study found associations between intra-uterine growth restriction and inadequate postnatal energy intake with delayed cognitive development and behavioral disorders. It also identified links between energy restriction in the first week of life with visual deficiency and cerebral palsy in this population.