03 Oct Fast Growth After Preterm Birth Linked To Persistent Neurocognitive Ability
Medical Research: What are the main findings of the study?
Answer: Not only did we find that faster growth right after preterm birth is
associated with better neurocognitive abilities – we also showed that
these effects persist into adulthood, that they are seen across a wide
spectrum of abilities, and that head growth very early on seems
especially relevant in predicting long-term outcomes. These
associations were found when we examined 103 young adults who were
born prematurely and with very low birth weight (under 1500 grams).
Medical Research: What was most surprising about the results?
Answer: We were not expecting to see associations that were quite so
consistent in highlighting the role of growth before term (i.e. “due
date”), even after accounting for many background factors and neonatal
complications. However, it makes sense that what happens during the
first weeks or months in the lives of these preterm infants is
crucial: after all, this is a time period the term-born individual
would be still spending in the womb while the brain undergoes an
intensive growth spurt.
Medical Research: What should clinicians and patients take away from your report?
Answer: Faster growth early in infancy, and head growth in particular, can
predict better long-term cognitive outcomes for preterm individuals.
Faster weight gain, especially later on in infancy, does not seem to
be quite as clearly associated with such beneficial effects, however.
Of course, it is worth noting that the studied cohort was born between
1978 and 1985, a time when neonatal nutrition and care was different
from what it is now, and thus one must be cautious when generalizing
the findings into today’s preterm infants.
Medical Research: What recommendations do you have for future research as a result of this study?
Answer: We need to study how these and other recent findings could improve
care for the preterm infant. Can nutritional programs or other
treatment practices alleviate the subtle (yet long-term) risk of
poorer neurocognitive functioning, which is associated with preterm
birth? And if so, how should they be targeted: should we be supporting
faster growth during the very first months but not thereafter, to
avoid possible cardiovascular risks? As a result of this study, we see
a possible direction for targeted interventions, but more research is
needed to assess how to best translate these intriguing findings into
Infant Growth after Preterm Birth and Neurocognitive Abilities in Young Adulthood
Sara Sammallahti, Riikka Pyhälä, Marius Lahti, Jari Lahti, Anu-Katriina Pesonen, Kati Heinonen, Petteri Hovi, Johan G. Eriksson, Sonja Strang-Karlsson, Sture Andersson, Anna-Liisa Järvenpää, Eero Kajantie, Katri Räikkönen
The Journal of Pediatrics – 29 September 2014 (10.1016/j.jpeds.2014.08.028)