Aim

Extra-uterine Growth Restriction (EUGR) is common among preterm infants. Two types of EUGR definitions are still now available: cross-sectional definitions and longitudinal ones. In a cohort of very preterm infants, we aimed to evaluate which definition could better predict neurodevelopmental outcomes at 2 years of corrected age. We used Italian Neonatal Study Charts (INeS) growth charts and INTERGROWTH-21st (IG-21) standard charts and compared results.

Method

We restrospectively collected data from clinical charts of 324 preterm newborns with a gestational age ≤30 weeks born from 2012 to 2017. Then we compared forty-eight definitions (24 cross-sectional and 24 longitudinal) of EUGR, in term of neurodevelopmental outcomes at 2 years of corrected age.

Results

We included in the study 254 preterm infants, whose clinical information met the enrolment criteria. Nineteen out of 48 definitions of EUGR were significantly predictive both for Griffith's Development Quotient (GDQ) and Neurodevelopment Impairment (NDI). Among these, longitudinal definitions appeared to have a higher negative predictive value for NDI than cross-sectional ones. Furthermore, infants with EUGR appeared to have a lower cognitive score than their peers without EUGR.

Interpretation

A loss of Zs > 1 SDS in weight and head circumference, calculated from when physiological weight loss is over and identified as soon as possible rather than at discharge, better predicts neurodevelopmental outcomes of preterm infants.

中文翻译：

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早产儿宫外生长受限：不同定义下的神经发育结局

目的

宫外生长受限 (EUGR) 在早产儿中很常见。现在仍有两种类型的 EUGR 定义：横截面定义和纵向定义。在一组极早产儿中，我们旨在评估哪种定义可以更好地预测 2 岁矫正年龄时的神经发育结果。我们使用意大利新生儿研究图表 (INeS) 生长图表和 INTERGROWTH-21st (IG-21) 标准图表并比较结果。

方法

我们从 2012 年至 2017 年出生的 324 名胎龄≤30 周早产儿的临床病历中回顾性收集数据。然后我们比较了 EUGR 的 48 个定义（24 个横断面和 24 个纵轴），在 2年矫正年龄。

结果

我们在研究中纳入了 254 名早产儿，其临床信息符合纳入标准。EUGR 的 48 个定义中有 19 个对格里菲斯发育商数 (GDQ) 和神经发育障碍 (NDI) 具有显着预测性。其中，纵向定义似乎比横截面定义对 NDI 具有更高的阴性预测值。此外，具有 EUGR 的婴儿的认知评分似乎低于没有 EUGR 的同龄人。

解释

体重和头围的 Zs 损失 > 1 SDS，从生理性体重减轻结束时计算并尽快确定，而不是在出院时，可以更好地预测早产儿的神经发育结果。