Growth after late-preterm birth and adult cognitive, academic, and mental health outcomes

Pediatr Res. 2017 May;81(5):767-774. doi: 10.1038/pr.2016.276. Epub 2017 Jan 5.

Abstract

Background: Late-preterm birth (at 340⁄7-366⁄7 wk gestation) increases the risk of early growth faltering, poorer neurocognitive functioning, and lower socio-economic attainment. Among early-preterm individuals, faster early growth benefits neurodevelopment, but it remains unknown whether these benefits extend to late-preterm individuals.

Methods: In 108 late-preterm individuals, we examined if weight, head, or length growth between birth, 5 and 20 months' corrected age, and 56 mo, predicted grade point average and special education in comprehensive school, or neurocognitive abilities and psychiatric diagnoses/symptoms at 24-26 y of age.

Results: For every 1 SD faster weight and head growth from birth to 5 mo, and head growth from 5 to 20 mo, participants had 0.19-0.41 SD units higher IQ, executive functioning score, and grade point average (95% confidence intervals (CI) 0.002-0.59 SD), and lower odds of special education (odds ratio (OR) = 0.49-0.59, 95% CIs 0.28-0.97), after adjusting for sex, gestational age, follow-up age, and parental education. Faster head growth from 20 to 56 mo was associated with less internalizing problems; otherwise we found no consistent associations with mental health outcomes.

Conclusion: Faster growth during the critical early period after late-preterm birth is associated with better adult neurocognitive functioning, but not consistently with mental health outcomes.

MeSH terms

  • Adolescent
  • Adolescent Development*
  • Adult
  • Age Factors
  • Aging / psychology*
  • Child
  • Child Development*
  • Child, Preschool
  • Cognition*
  • Education, Special
  • Educational Status*
  • Executive Function
  • Female
  • Gestational Age
  • Head / growth & development
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature / psychology*
  • Linear Models
  • Longitudinal Studies
  • Male
  • Mental Health*
  • Neuropsychological Tests
  • Odds Ratio
  • Premature Birth / psychology*
  • Prospective Studies
  • Risk Factors
  • Weight Gain
  • Young Adult