Association between preterm-birth phenotypes and differential morbidity, growth, and neurodevelopment at age 2 years. Results from the INTERBIO-21st Newborn Study
<br><strong>Importance </strong>The etiologic complexities of preterm birth remain inadequately understood, which may impede the development of better preventative and treatment measures. <br><strong> Objective </strong>To examine the association between specifi...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Formato: | Journal article |
| Idioma: | English |
| Publicado: |
American Medical Association
2021
|
| _version_ | 1826310690011348992 |
|---|---|
| author | Villar, J Mcgready, R Papageorghiou, A Fernandes, M Craik, R Cheikh Ismail, L Lambert, A Ohuma, E Stein, A Zondervan, K Winsey, F Nosten, F Kennedy, S |
| author_facet | Villar, J Mcgready, R Papageorghiou, A Fernandes, M Craik, R Cheikh Ismail, L Lambert, A Ohuma, E Stein, A Zondervan, K Winsey, F Nosten, F Kennedy, S |
| author_sort | Villar, J |
| collection | OXFORD |
| description | <br><strong>Importance </strong>The etiologic complexities of preterm birth remain inadequately understood, which may impede the development of better preventative and treatment measures.
<br><strong>
Objective </strong>To examine the association between specific preterm-birth phenotypes and clinical, growth, and neurodevelopmental differences among preterm newborns compared with term newborns up to age 2 years.
<br><strong>
Design, Setting, and Participants </strong>The INTERBIO-21st study included a cohort of preterm and term newborn singletons enrolled between March 2012 and June 2018 from maternity hospitals in 6 countries worldwide who were followed up from birth to age 2 years. All pregnancies were dated by ultrasonography. Data were analyzed from November 2019 to October 2020.
<br><strong>
Exposures/Interventions </strong>Preterm-birth phenotypes.
<br><strong>
Main Outcomes and Measures </strong>Infant size, health, nutrition, and World Health Organization motor development milestones assessed at ages 1 and 2 years; neurodevelopment evaluated at age 2 years using the INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA) tool.
<br><strong>
Results </strong>A total of 6529 infants (3312 boys [50.7%]) were included in the analysis. Of those, 1381 were preterm births (mean [SD] gestational age at birth, 34.4 [0.1] weeks; 5148 were term births (mean [SD] gestational age at birth, 39.4 [0] weeks). Among 1381 preterm newborns, 8 phenotypes were identified: no main maternal, fetal, or placental condition detected (485 infants [35.1%]); infections (289 infants [20.9%]); preeclampsia (162 infants [11.7%]); fetal distress (131 infants [9.5%]); intrauterine growth restriction (110 infants [8.0%]); severe maternal disease (85 infants [6.2%]); bleeding (71 infants [5.1%]); and congenital anomaly (48 infants [3.5%]). For all phenotypes, a previous preterm birth was a risk factor for recurrence. Each phenotype displayed differences in neonatal morbidity and infant outcomes. For example, infants with the no main condition detected phenotype had low neonatal morbidity but increased morbidity and hospitalization incidence at age 1 year (odds ratio [OR], 2.2; 95% CI, 1.8-2.7). Compared with term newborns, the highest risk of scoring lower than the 10th centile of INTER-NDA normative values was observed in the fine motor development domain among newborns with the fetal distress (OR, 10.6; 95% CI, 5.1-22.2) phenotype.
<br><strong>
Conclusions and Relevance </strong>Results of this study suggest that phenotypic classification may provide a better understanding of the etiologic factors and mechanisms associated with preterm birth than continuing to consider it an exclusively time-based entity. |
| first_indexed | 2024-03-07T07:57:10Z |
| format | Journal article |
| id | oxford-uuid:37788500-59b7-4973-89f7-e9286ebd7c9c |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:57:10Z |
| publishDate | 2021 |
| publisher | American Medical Association |
| record_format | dspace |
| spelling | oxford-uuid:37788500-59b7-4973-89f7-e9286ebd7c9c2023-08-31T10:02:21Z Association between preterm-birth phenotypes and differential morbidity, growth, and neurodevelopment at age 2 years. Results from the INTERBIO-21st Newborn StudyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:37788500-59b7-4973-89f7-e9286ebd7c9cEnglishSymplectic ElementsAmerican Medical Association2021Villar, JMcgready, RPapageorghiou, AFernandes, MCraik, RCheikh Ismail, LLambert, AOhuma, EStein, AZondervan, KWinsey, FNosten, FKennedy, S<br><strong>Importance </strong>The etiologic complexities of preterm birth remain inadequately understood, which may impede the development of better preventative and treatment measures. <br><strong> Objective </strong>To examine the association between specific preterm-birth phenotypes and clinical, growth, and neurodevelopmental differences among preterm newborns compared with term newborns up to age 2 years. <br><strong> Design, Setting, and Participants </strong>The INTERBIO-21st study included a cohort of preterm and term newborn singletons enrolled between March 2012 and June 2018 from maternity hospitals in 6 countries worldwide who were followed up from birth to age 2 years. All pregnancies were dated by ultrasonography. Data were analyzed from November 2019 to October 2020. <br><strong> Exposures/Interventions </strong>Preterm-birth phenotypes. <br><strong> Main Outcomes and Measures </strong>Infant size, health, nutrition, and World Health Organization motor development milestones assessed at ages 1 and 2 years; neurodevelopment evaluated at age 2 years using the INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA) tool. <br><strong> Results </strong>A total of 6529 infants (3312 boys [50.7%]) were included in the analysis. Of those, 1381 were preterm births (mean [SD] gestational age at birth, 34.4 [0.1] weeks; 5148 were term births (mean [SD] gestational age at birth, 39.4 [0] weeks). Among 1381 preterm newborns, 8 phenotypes were identified: no main maternal, fetal, or placental condition detected (485 infants [35.1%]); infections (289 infants [20.9%]); preeclampsia (162 infants [11.7%]); fetal distress (131 infants [9.5%]); intrauterine growth restriction (110 infants [8.0%]); severe maternal disease (85 infants [6.2%]); bleeding (71 infants [5.1%]); and congenital anomaly (48 infants [3.5%]). For all phenotypes, a previous preterm birth was a risk factor for recurrence. Each phenotype displayed differences in neonatal morbidity and infant outcomes. For example, infants with the no main condition detected phenotype had low neonatal morbidity but increased morbidity and hospitalization incidence at age 1 year (odds ratio [OR], 2.2; 95% CI, 1.8-2.7). Compared with term newborns, the highest risk of scoring lower than the 10th centile of INTER-NDA normative values was observed in the fine motor development domain among newborns with the fetal distress (OR, 10.6; 95% CI, 5.1-22.2) phenotype. <br><strong> Conclusions and Relevance </strong>Results of this study suggest that phenotypic classification may provide a better understanding of the etiologic factors and mechanisms associated with preterm birth than continuing to consider it an exclusively time-based entity. |
| spellingShingle | Villar, J Mcgready, R Papageorghiou, A Fernandes, M Craik, R Cheikh Ismail, L Lambert, A Ohuma, E Stein, A Zondervan, K Winsey, F Nosten, F Kennedy, S Association between preterm-birth phenotypes and differential morbidity, growth, and neurodevelopment at age 2 years. Results from the INTERBIO-21st Newborn Study |
| title | Association between preterm-birth phenotypes and differential morbidity, growth, and neurodevelopment at age 2 years. Results from the INTERBIO-21st Newborn Study |
| title_full | Association between preterm-birth phenotypes and differential morbidity, growth, and neurodevelopment at age 2 years. Results from the INTERBIO-21st Newborn Study |
| title_fullStr | Association between preterm-birth phenotypes and differential morbidity, growth, and neurodevelopment at age 2 years. Results from the INTERBIO-21st Newborn Study |
| title_full_unstemmed | Association between preterm-birth phenotypes and differential morbidity, growth, and neurodevelopment at age 2 years. Results from the INTERBIO-21st Newborn Study |
| title_short | Association between preterm-birth phenotypes and differential morbidity, growth, and neurodevelopment at age 2 years. Results from the INTERBIO-21st Newborn Study |
| title_sort | association between preterm birth phenotypes and differential morbidity growth and neurodevelopment at age 2 years results from the interbio 21st newborn study |
| work_keys_str_mv | AT villarj associationbetweenpretermbirthphenotypesanddifferentialmorbiditygrowthandneurodevelopmentatage2yearsresultsfromtheinterbio21stnewbornstudy AT mcgreadyr associationbetweenpretermbirthphenotypesanddifferentialmorbiditygrowthandneurodevelopmentatage2yearsresultsfromtheinterbio21stnewbornstudy AT papageorghioua associationbetweenpretermbirthphenotypesanddifferentialmorbiditygrowthandneurodevelopmentatage2yearsresultsfromtheinterbio21stnewbornstudy AT fernandesm associationbetweenpretermbirthphenotypesanddifferentialmorbiditygrowthandneurodevelopmentatage2yearsresultsfromtheinterbio21stnewbornstudy AT craikr associationbetweenpretermbirthphenotypesanddifferentialmorbiditygrowthandneurodevelopmentatage2yearsresultsfromtheinterbio21stnewbornstudy AT cheikhismaill associationbetweenpretermbirthphenotypesanddifferentialmorbiditygrowthandneurodevelopmentatage2yearsresultsfromtheinterbio21stnewbornstudy AT lamberta associationbetweenpretermbirthphenotypesanddifferentialmorbiditygrowthandneurodevelopmentatage2yearsresultsfromtheinterbio21stnewbornstudy AT ohumae associationbetweenpretermbirthphenotypesanddifferentialmorbiditygrowthandneurodevelopmentatage2yearsresultsfromtheinterbio21stnewbornstudy AT steina associationbetweenpretermbirthphenotypesanddifferentialmorbiditygrowthandneurodevelopmentatage2yearsresultsfromtheinterbio21stnewbornstudy AT zondervank associationbetweenpretermbirthphenotypesanddifferentialmorbiditygrowthandneurodevelopmentatage2yearsresultsfromtheinterbio21stnewbornstudy AT winseyf associationbetweenpretermbirthphenotypesanddifferentialmorbiditygrowthandneurodevelopmentatage2yearsresultsfromtheinterbio21stnewbornstudy AT nostenf associationbetweenpretermbirthphenotypesanddifferentialmorbiditygrowthandneurodevelopmentatage2yearsresultsfromtheinterbio21stnewbornstudy AT kennedys associationbetweenpretermbirthphenotypesanddifferentialmorbiditygrowthandneurodevelopmentatage2yearsresultsfromtheinterbio21stnewbornstudy |