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Neurodevelopmental outcomes in postnatal growth-restricted preterm infants with postnatal head-sparing
Meyers, J. M., Bann, C. M., Stoll, B. J., D'Angio, C. T., Bell, E. F., Duncan, A. F., Guillet, R., & Eunice Kennedy Shriver Natl Inst (2016). Neurodevelopmental outcomes in postnatal growth-restricted preterm infants with postnatal head-sparing. Journal of Perinatology, 36(12), 1116-1121. https://doi.org/10.1038/jp.2016.154, https://doi.org/10.1038/jp.2016.154
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.