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Weight, length, and head circumference at 36 weeks are not predictive of later cognitive impairment in very preterm infants



To assess diagnostic accuracy of 36-week anthropometric weight, length, and head circumference <10th and <3rd percentiles to predict preterm infant cognitive impairment.

Study design

Cohort study of 898 preterm <30-week very-low-birth weight (<1500 g) infants. Anthropometric measures’ accuracy to predict cognitive impairment (Bayley-III Cognitive Composite score) <80, 21-months corrected age (CA) and Wechsler Preschool and Primary Scale of Intelligence Quotient (intellectual outcomes) <70, 36-months CA, were determined using receiver operating characteristic (ROC) curves.


Thirty-six-week weight, length or head circumference <10th or <3rd percentile did not predict cognitive impairment; areas under ROC curves were <0.6. Sensitivities and specificities for 10th and 3rd percentile cut points were all poor, with most not exceeding 70%, whether the Fenton 2013 or INTERGROWTH 2015 growth charts were used. Brain injury and low maternal education were better predictors of cognitive impairment.


Preterm infant 36-week anthropometric measurements are not accurate predictors of cognitive impairment.

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Fig. 1: Anthropometric measurements at 36 weeks were not predictive of cognitive scores.
Fig. 2: The addition of low maternal education and morbidities significantly increased the accuracy of predicting cognitive impairments.

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We wish to thank the Neonatologists, Nurses, Dietitians, and other staff who cared for the infants in this study, and the parents who provided consent for their infants’ data to be used in research. We thank Megan Ramsay, Ninfa Garay, Michelle Matiation, Sara Leuenberger, Jasmine Shourounis, Tian Huang for their excellent data collection and Lynn Rotariu and Kim Fichter from Health Records.


This study is funded by Canadian Foundation for Dietetic Research. The funders had no role in the analysis or interpretation of the data.

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Correspondence to Tanis R. Fenton.

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Fenton, T.R., Nasser, R., Creighton, D. et al. Weight, length, and head circumference at 36 weeks are not predictive of later cognitive impairment in very preterm infants. J Perinatol 41, 606–614 (2021).

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