Evaluation of Extrauterine Head Growth From 14-21 days to Discharge With Longitudinal Intergrowth-21st Charts: A New Approach to Identify Very Preterm Infants at Risk of Long-Term Neurodevelopmental Impairment
Background: ExtraUterine Growth Restriction (EUGR) is a common definition for in-hospital growth failure of very preterm infants. Wide heterogeneity is found in definitions and anthropometric charts used to describe EUGR.Aim: We aim to compare two traditional definitions of EUGR with a newly propose...
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| Format: | Article |
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Frontiers Media S.A.
2020-11-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2020.572930/full |
| _version_ | 1818694768967811072 |
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| author | Giulia Maiocco Giuseppe Migliaretti Francesco Cresi Chiara Peila Sonia Deantoni Beatrice Trapani Francesca Giuliani Enrico Bertino Alessandra Coscia |
| author_facet | Giulia Maiocco Giuseppe Migliaretti Francesco Cresi Chiara Peila Sonia Deantoni Beatrice Trapani Francesca Giuliani Enrico Bertino Alessandra Coscia |
| author_sort | Giulia Maiocco |
| collection | DOAJ |
| description | Background: ExtraUterine Growth Restriction (EUGR) is a common definition for in-hospital growth failure of very preterm infants. Wide heterogeneity is found in definitions and anthropometric charts used to describe EUGR.Aim: We aim to compare two traditional definitions of EUGR with a newly proposed one, based on a longitudinal evaluation, that takes into account the physiological period of fluid loss after birth. We also wish to detect which definition could better predict neurodevelopmental impairment at 24 months of corrected age (CA).Methods: A total of 195 infants with GA < 30 were included. EUGR was calculated both for weight and head circumference (HC). Cross-sectional EUGR was defined as measurements < 10th percentile at discharge; longitudinal EUGR was defined as Δz-score < −1 between birth and discharge measurements. The new longitudinal “post-loss” EUGR definition was proposed as Δz-score < −1 between measurements taken at 14–21 days of life and at discharge. Longitudinal postnatal Intergrowth-21st charts specifically built on preterm infants were used. Association with major and minor neurodevelopmental impairment at 24-month CA was assessed for each definition. K coefficient and ROC curve were evaluated.Results: Longitudinal “post-loss” definition of EUGR for HC is the one predicting minor neurodevelopmental impairment at the multivariate analysis (OR = 3.94), and it is also associated with a worse General Quotient. The chosen cut-off (Δz-score < −1) is the proper one.Conclusion: HC in-hospital growth could be a more accurate tool than weight to predict neurodevelopmental outcomes and especially minor neurological impairment. Longitudinal “post-loss” definition of EUGR assessed on longitudinal charts for preterm infants could be the most appropriate definition from the methodological, clinical, and prognostic point of view. |
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| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-17T13:34:50Z |
| publishDate | 2020-11-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Pediatrics |
| spelling | doaj.art-7eb9956db85241889f1fe69d29ff57622022-12-21T21:46:28ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602020-11-01810.3389/fped.2020.572930572930Evaluation of Extrauterine Head Growth From 14-21 days to Discharge With Longitudinal Intergrowth-21st Charts: A New Approach to Identify Very Preterm Infants at Risk of Long-Term Neurodevelopmental ImpairmentGiulia Maiocco0Giuseppe Migliaretti1Francesco Cresi2Chiara Peila3Sonia Deantoni4Beatrice Trapani5Francesca Giuliani6Enrico Bertino7Alessandra Coscia8Neonatal Care Unit, Department of Public Health and Pediatric Sciences, University of Turin, Turin, ItalyStatistical Unit, Department of Public Health and Pediatric Sciences, University of Turin, Turin, ItalyNeonatal Care Unit, Department of Public Health and Pediatric Sciences, University of Turin, Turin, ItalyNeonatal Care Unit, Department of Public Health and Pediatric Sciences, University of Turin, Turin, ItalyNeonatal Care Unit, Department of Public Health and Pediatric Sciences, University of Turin, Turin, ItalyNeonatal Care Unit, Department of Public Health and Pediatric Sciences, University of Turin, Turin, ItalyNeonatal Care Unit, Department of Public Health and Pediatric Sciences, University of Turin, Turin, ItalyNeonatal Care Unit, Department of Public Health and Pediatric Sciences, University of Turin, Turin, ItalyNeonatal Care Unit, Department of Public Health and Pediatric Sciences, University of Turin, Turin, ItalyBackground: ExtraUterine Growth Restriction (EUGR) is a common definition for in-hospital growth failure of very preterm infants. Wide heterogeneity is found in definitions and anthropometric charts used to describe EUGR.Aim: We aim to compare two traditional definitions of EUGR with a newly proposed one, based on a longitudinal evaluation, that takes into account the physiological period of fluid loss after birth. We also wish to detect which definition could better predict neurodevelopmental impairment at 24 months of corrected age (CA).Methods: A total of 195 infants with GA < 30 were included. EUGR was calculated both for weight and head circumference (HC). Cross-sectional EUGR was defined as measurements < 10th percentile at discharge; longitudinal EUGR was defined as Δz-score < −1 between birth and discharge measurements. The new longitudinal “post-loss” EUGR definition was proposed as Δz-score < −1 between measurements taken at 14–21 days of life and at discharge. Longitudinal postnatal Intergrowth-21st charts specifically built on preterm infants were used. Association with major and minor neurodevelopmental impairment at 24-month CA was assessed for each definition. K coefficient and ROC curve were evaluated.Results: Longitudinal “post-loss” definition of EUGR for HC is the one predicting minor neurodevelopmental impairment at the multivariate analysis (OR = 3.94), and it is also associated with a worse General Quotient. The chosen cut-off (Δz-score < −1) is the proper one.Conclusion: HC in-hospital growth could be a more accurate tool than weight to predict neurodevelopmental outcomes and especially minor neurological impairment. Longitudinal “post-loss” definition of EUGR assessed on longitudinal charts for preterm infants could be the most appropriate definition from the methodological, clinical, and prognostic point of view.https://www.frontiersin.org/articles/10.3389/fped.2020.572930/fullextrauterine growth restriction (EUGR)anthropometric chartsneurodevelopmental outcomes of very preterm infantsIntergrowth-21st standardsextrauterine growth of head size |
| spellingShingle | Giulia Maiocco Giuseppe Migliaretti Francesco Cresi Chiara Peila Sonia Deantoni Beatrice Trapani Francesca Giuliani Enrico Bertino Alessandra Coscia Evaluation of Extrauterine Head Growth From 14-21 days to Discharge With Longitudinal Intergrowth-21st Charts: A New Approach to Identify Very Preterm Infants at Risk of Long-Term Neurodevelopmental Impairment Frontiers in Pediatrics extrauterine growth restriction (EUGR) anthropometric charts neurodevelopmental outcomes of very preterm infants Intergrowth-21st standards extrauterine growth of head size |
| title | Evaluation of Extrauterine Head Growth From 14-21 days to Discharge With Longitudinal Intergrowth-21st Charts: A New Approach to Identify Very Preterm Infants at Risk of Long-Term Neurodevelopmental Impairment |
| title_full | Evaluation of Extrauterine Head Growth From 14-21 days to Discharge With Longitudinal Intergrowth-21st Charts: A New Approach to Identify Very Preterm Infants at Risk of Long-Term Neurodevelopmental Impairment |
| title_fullStr | Evaluation of Extrauterine Head Growth From 14-21 days to Discharge With Longitudinal Intergrowth-21st Charts: A New Approach to Identify Very Preterm Infants at Risk of Long-Term Neurodevelopmental Impairment |
| title_full_unstemmed | Evaluation of Extrauterine Head Growth From 14-21 days to Discharge With Longitudinal Intergrowth-21st Charts: A New Approach to Identify Very Preterm Infants at Risk of Long-Term Neurodevelopmental Impairment |
| title_short | Evaluation of Extrauterine Head Growth From 14-21 days to Discharge With Longitudinal Intergrowth-21st Charts: A New Approach to Identify Very Preterm Infants at Risk of Long-Term Neurodevelopmental Impairment |
| title_sort | evaluation of extrauterine head growth from 14 21 days to discharge with longitudinal intergrowth 21st charts a new approach to identify very preterm infants at risk of long term neurodevelopmental impairment |
| topic | extrauterine growth restriction (EUGR) anthropometric charts neurodevelopmental outcomes of very preterm infants Intergrowth-21st standards extrauterine growth of head size |
| url | https://www.frontiersin.org/articles/10.3389/fped.2020.572930/full |
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