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Neurodevelopmental outcomes in postnatal growth-restricted preterm infants with postnatal head-sparing

Journal of Perinatology volume 36, pages 1116–1121 (2016)Cite this article

Subjects

Abstract

Objective:

To compare neurodevelopmental outcomes in postnatal growth-restricted infants born <29 weeks with and without postnatal head-sparing (PHS).

Study Design:

We analyzed developmental outcomes at 2 years of age among postnatally growth-restricted infants with and without head-sparing. The primary outcome was Bayley III cognitive composite score; secondary outcomes included Bayley III motor composite score, moderate/severe cerebral palsy, gross motor functional classification scale level⩾2, and presence or absence of neurodevelopmental impairment (NDI).

Results:

Of 1098 infants evaluated at 18 to 22 months, 658 were postnatally growth restricted, of whom 301 had head-sparing. In the multivariate model including independent risk factors for poor growth and poor developmental outcome, infants with head-sparing had higher adjusted motor composite scores (mean difference 4.65, P<0.01), but no differences in other neurodevelopmental outcomes.

Conclusion:

PHS is associated with improved neurodevelopmental outcome in extremely preterm infants, specifically Bayley III motor scores, but whether beneficial effects of PHS persist later in life is unknown.

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Acknowledgements

The National Institutes of Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) provided grant support for the Neonatal Research Network’s Generic Database and Follow-up Study through cooperative agreements. While NICHD staff did have input into the study design, conduct, analysis, and manuscript drafting, the comments and views of the authors do not necessarily represent the views of the NICHD.

Data collected at participating sites of the NICHD Neonatal Research Network (NRN) were transmitted to RTI International, the data coordinating center (DCC) for the network, which stored, managed and analyzed the data for this study. On behalf of the NRN, Drs Abhik Das (DCC Principal Investigator) and Carla M Bann (DCC Statistician) had full access to all the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis.

We are indebted to our medical and nursing colleagues and the infants and their parents who agreed to take part in this study. The following investigators, in addition to those listed as authors, participated in this study:

NRN Steering Committee Chair: Michael S Caplan, MD, University of Chicago, Pritzker School of Medicine; Richard A Polin, MD, Division of Neonatology, College of Physicians and Surgeons, Columbia University (2011–present).

Alpert Medical School of Brown University and Women & Infants Hospital of Rhode Island (U10 HD27904)—Abbot R Laptook, MD; Angelita M Hensman, MS RNC-NIC; William Oh, MD; Martin Keszler, MD; Betty R Vohr, MD; Robert Burke, MD; Melinda Caskey, MD; Katharine Johnson, MD; Elisabeth C McGowan MD; Barbara Alksninis, PNP; Mary Lenore Keszler, MD; Theresa M Leach, MEd CAES; Bonnie E Stephens, MD; Victoria E Watson, MS CAS; Suzy Ventura; Kristin M Basso, MS BSN; Elisa Vieira, RN BSN; Andrea M Knolls; Kristin M Basso, MaT RN; Elisa Vieira, RN BSN.

Case Western Reserve University, Rainbow Babies & Children's Hospital (U10 HD21364, M01 RR80)—Michele C Walsh, MD MS; Avroy A Fanaroff, MD; Anna Marie Hibbs, MD; Deanne E Wilson-Costello, MD; Nancy S Newman, BA RN; Bonnie S Siner, RN; Monika Bhola, MD; Gulgun Yalcinkaya, MD; Harriet G Friedman, MA.

Cincinnati Children's Hospital Medical Center, University Hospital, and Good Samaritan Hospital (U10 HD27853, M01 RR8084)—Kurt Schibler, MD; Edward F Donovan, MD; Kate Bridges, MD; Barbara Alexander, RN; Cathy Grisby, BSN CCRC; Jody Hessling, RN; Estelle E Fischer, MHSA MBA; Lenora D Jackson, CRC; Kristin Kirker, CRC; Holly L Mincey, RN BSN; Greg Muthig, BS; Teresa L Gratton, PA; Jean J Steichen, MD; Kimberly Yolton, PhD.

Duke University School of Medicine, University Hospital, University of North Carolina, and Duke Regional Hospital (U10 HD40492, M01 RR30, UL1 TR83)—Ronald N Goldberg, MD; C Michael Cotten, MD MHS; Ricki F Goldstein, MD; William F Malcolm, MD; Patricia L Ashley, MD; Kimberley A Fisher, PhD FNP-BC IBCLC; Sandra Grimes, RN BSN; Joanne Finkle, RN JD; Kathryn E Gustafson, PhD; Matthew M Laughon, MD MPH; Carl L Bose, MD; Janice Bernhardt, MS RN; Gennie Bose, RN; Janice K Wereszczak, CPNP-AC/PC.

Emory University, Children’s Healthcare of Atlanta, Grady Memorial Hospital, and Emory University Hospital Midtown (U10 HD27851, UL1 TR454)—David P Carlton, MD; Ellen C Hale, RN BS CCRC; Yvonne Loggins, RN BSN; Diane Bottcher, RN MN; Ira Adams-Chapman, MD; Maureen Mulligan LaRossa, RN; Sheena L Carter, PhD.

Eunice Kennedy Shriver National Institute of Child Health and Human Development—Rosemary D Higgins, MD; Stephanie Wilson Archer, MA.

Indiana University, University Hospital, Methodist Hospital, Riley Hospital for Children, and Eskenazi Health (U10 HD27856, M01 RR750, UL1 TR6)—Brenda B Poindexter, MD MS; Gregory M Sokol, MD; Anna M Dusick, MD (deceased); Heidi Harmon, MD MS; Dianne E Herron, RN; Lucy Smiley, CCRC; Carolyn Lytle, MD MPH; Lucy C Miller, RN BSN CCRC; Heike M Minnich, PsyD HSPP; Abbey C Hines, PsyD; Leslie Dawn Wilson, BSN CCRC.

RTI International (U10 HD36790)—Abhik Das, PhD; Dennis Wallace, PhD; Jamie E Newman, PhD MPH; Jeanette O’Donnell Auman, BS; Margaret M Crawford, BS CCRP; Marie G Gantz, PhD; Carolyn M Petrie Huitema, MS CCRP; Kristin M Zaterka-Baxter, RN BSN CCRP.

Stanford University, Dominican Hospital, El Camino Hospital, and Lucile Packard Children's Hospital (U10 HD27880, M01 RR70, UL1 TR93)—Krisa P Van Meurs, MD; David K Stevenson, MD; Susan R Hintz, MD MS Epi; Marian M Adams, MD; M Bethany Ball, BS CCRC; Andrew W Palmquist, RN BSN; Melinda S Proud, RCP; Barbara Bentley, PhD; Elizabeth Bruno, PhD; Maria Elena DeAnda, PhD; Anne M DeBattista, RN PNP; Lynne C Huffman, MD Jean G Kohn, MD MPH; Casey E Krueger, PhD; Brian Tang, MD; Hali E Weiss, MD.

Tufts Medical Center, Floating Hospital for Children (U10 HD53119, M01 RR54)—Ivan D Frantz III, MD; John M Fiascone, MD; Brenda L MacKinnon, RNC; Ellen Nylen, RN BSN; Anne Furey, MPH; Elisabeth C McGowan, MD; Cecelia E Sibley PT MHA; Ana K Brussa, MS OTR/L.

University of Alabama at Birmingham Health System and Children’s Hospital of Alabama (U10 HD34216, M01 RR32)—Waldemar A Carlo, MD; Namasivayam Ambalavanan, MD; Myriam Peralta-Carcelen, MD MPH; Monica V Collins, RN BSN MaEd; Shirley S Cosby, RN BSN; Fred J Biasini, PhD; Kristen C Johnston, MSN CRNP; Kathleen G Nelson, MD; Cryshelle S Patterson, PhD; Vivien A Phillips, RN BSN; Sally Whitley, MA OTR-L FAOTA; Amanda D Soong, MD; Carin Kiser, MD; Leigh Ann Smith, CRNP; Sara Kryzwanski, MS; Richard V Rector, PhD; Sarah Ryan, PhD; Kristy Domnanovich, PhD; Leslie Rodrigues, PhD.

University of California, San Diego Medical Center and Sharp Mary Birch Hospital for Women and Newborns (U10 HD40461)—Neil N Finer, MD; Yvonne E Vaucher, MD MPH; David Kaegi, MD; Maynard R Rasmussen, MD; Kathy Arnell, RNC; Clarence Demetrio, RN; Martha G Fuller, RN MSN; Chris Henderson, RCP CRTT; Wade Rich, BSHS RRT; Radmila West PhD.

University of Iowa and Mercy Medical Center (U10 HD53109, M01 RR59)—Dan L Ellsbury, MD; John A Widness, MD; Tarah T Colaizy, MD MPH; Jane E Brumbaugh, MD; Michael J Acarregui, MD; Diane L Eastman, RN CPNP MA; Karen J Johnson, RN BSN; Donia B Campbell, RNC-NIC; Jacky R Walker, RN.

University of New Mexico Health Sciences Center (U10 HD53089, UL1 TR41)—Kristi L Watterberg, MD; Robin K Ohls, MD; Janell F Fuller, MD; Conra Backstrom Lacy, RN; Rebecca A Montman, BSN RNC; Jean R Lowe, PhD; Carol Hartenberger, BSN MPH.

University of Rochester Medical Center, Golisano Children’s Hospital, and the University of Buffalo Women's and Children's Hospital of Buffalo (U10 HD68263, U10 HD40521, M01 RR44, UL1 TR42—Carl T D’Angio, MD.

University of Texas Health Science Center at Houston Medical School, Children's Memorial Hermann Hospital (U10 HD21373)—Kathleen A Kennedy, MD MPH; Jon E Tyson, MD MPH; Allison Dempsey, PhD; Patricia W Evans, MD; Charles E Green, PhD; Margarita Jiminez, MD MPH; Janice John, CPNP; Patrick M Jones, MD MA, Georgia E McDavid, RN; M Layne Poundstone, RN BSN; Saba Siddiki, MD; Daniel Sperry, RN; Patti L Pierce Tate, RCP; Sharon L Wright, MT (ASCP).

University of Texas Southwestern Medical Center at Dallas, Parkland Health & Hospital System, and Children's Medical Center Dallas (U10 HD40689, M01 RR633)—Pablo J Sánchez, MD; Roy J Heyne, MD; Luc P Brion, MD; LiJun Chen, RN, PhD; Alicia Guzman; Melissa H Leps, RN; Nancy A Miller, RN; Diana M Vasil, RNC-NIC; Lizette E Torres, RN; Sally S Adams, MS RN CPNP; Linda A Madden, RN CPNP; Elizabeth Heyne, PsyD PA-C; Catherine Twell Boatman, MS CIMI.

University of Utah University Hospital, Intermountain Medical Center, LDS Hospital, and Primary Children's Medical Center (U10 HD53124, M01 RR64, UL1 TR105)—Roger G Faix, MD; Bradley A Yoder, MD; Anna Bodnar, MD; Karen A Osborne, RN BSN CCRC; Shawna Baker, RN; Karie Bird, RN BSN; Jill Burnett, RNC BSN; Jennifer J Jensen, RN BSN; Manndi C Loertscher, BS CCRP; Carrie A Rau, RN BSN CCRC; Cynthia Spencer, RNC BSN; Mike Steffen, PhD; Kimberlee Weaver-Lewis, RN MS; Sarah Winter, MD; Karen Zanetti, RN.

Wayne State University, University of Michigan, Hutzel Women’s Hospital, and Children’s Hospital of Michigan (U10 HD21385)—Seetha Shankaran, MD; Athina Pappas, MD; John Barks, MD; Martha Carlson, MD; Angela Argento; PhD; Rebecca Bara, RN BSN; Laura A Goldston, MA; Mary Johnson, RN BSN; Mary Christensen, RT; Stephanie Wiggins, MS.

Yale University, Yale-New Haven Children’s Hospital, and Bridgeport Hospital (U10 HD27871, UL1-RR024139, UL1 TR142)—Richard A Ehrenkranz, MD; Harris Jacobs, MD; Christine G Butler, MD; Patricia Cervone, RN; Sheila Greisman, RN; Monica Konstantino, RN BSN; JoAnn Poulsen, RN; Janet Taft, RN BSN; Joanne Williams, RN BSN; Elaine Romano, MSN.

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Authors and Affiliations

  1. Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA,

    J M Meyers, C T D'Angio & R Guillet

  2. Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, NC, USA,

    C M Bann

  3. Department of Pediatrics, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, GA, USA,

    B J Stoll

  4. Department of Pediatrics, University of Iowa, Iowa City, IA, USA,

    E F Bell

  5. Department of Pediatrics, University of Texas Medical School at Houston, Houston, TX, USA,

    A F Duncan

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  1. J M Meyers
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  2. C M Bann
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Meyers, J., Bann, C., Stoll, B. et al. Neurodevelopmental outcomes in postnatal growth-restricted preterm infants with postnatal head-sparing. J Perinatol 36, 1116–1121 (2016). https://doi.org/10.1038/jp.2016.154

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