Dataset Information

Growth Asymmetry, Head Circumference, and Neurodevelopmental Outcomes in Infants with Single Ventricles.

ABSTRACT: OBJECTIVE:To assess the variability in asymmetric growth and its association with neurodevelopment in infants with single ventricle (SV). STUDY DESIGN:We analyzed weight-for-age z-score minus head circumference-for-age z-score (HCAZ), relative head growth (cm/kg), along with individual growth variables in subjects prospectively enrolled in the Infant Single Ventricle Trial. Associations between growth indices and scores on the Psychomotor Developmental Index (PDI) and Mental Developmental Index (MDI) of the Bayley Scales of Infant Development-II (BSID-II) at 14 months were assessed. RESULTS:Of the 230 subjects enrolled in the Infant Single Ventricle trial, complete growth data and BSID-II scores were available in 168 (73%). Across the cohort, indices of asymmetric growth varied widely at enrollment and before superior cavopulmonary connection (SCPC) surgery. BSID-II scores were not associated with these asymmetry indices. In bivariate analyses, greater pre-SCPC HCAZ correlated with higher MDI (r = 0.21; P = .006) and PDI (r = 0.38; P < .001) and a greater HCAZ increase from enrollment to pre-SCPC with higher PDI (r = 0.15; P = .049). In multivariable modeling, pre-SCPC HCAZ was an independent predictor of PDI (P = .03), but not MDI. CONCLUSION:In infants with SV, growth asymmetry was not associated with neurodevelopment at 14 months, but pre-SCPC HCAZ was associated with PDI. Asymmetric growth, important in other high-risk infants, is not a brain-sparing adaptation in infants with SV. TRIAL REGISTRATION:Clinicaltrials.gov: NCT00113087.

SUBMITTER: Miller TA

PROVIDER: S-EPMC4698012 | biostudies-literature | 2016 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Growth Asymmetry, Head Circumference, and Neurodevelopmental Outcomes in Infants with Single Ventricles.

Miller Thomas A TA Zak Victor V Shrader Peter P Ravishankar Chitra C Pemberton Victoria L VL Newburger Jane W JW Shillingford Amanda J AJ Dagincourt Nicholas N Cnota James F JF Lambert Linda M LM Sananes Renee R Richmond Marc E ME Hsu Daphne T DT Miller Stephen G SG Zyblewski Sinai C SC Williams Richard V RV

The Journal of pediatrics 20151017

<h4>Objective</h4>To assess the variability in asymmetric growth and its association with neurodevelopment in infants with single ventricle (SV).<h4>Study design</h4>We analyzed weight-for-age z-score minus head circumference-for-age z-score (HCAZ), relative head growth (cm/kg), along with individual growth variables in subjects prospectively enrolled in the Infant Single Ventricle Trial. Associations between growth indices and scores on the Psychomotor Developmental Index (PDI) and Mental Devel ...[more]

PMID: 26490132

Similar Datasets

Project description:BackgroundData reported during the past 5 years indicate that rates of survival have increased among infants born at the borderline of viability, but less is known about how increased rates of survival among these infants relate to early childhood neurodevelopmental outcomes.MethodsWe compared survival and neurodevelopmental outcomes among infants born at 22 to 24 weeks of gestation, as assessed at 18 to 22 months of corrected age, across three consecutive birth-year epochs (2000-2003 [epoch 1], 2004-2007 [epoch 2], and 2008-2011 [epoch 3]). The infants were born at 11 centers that participated in the National Institute of Child Health and Human Development Neonatal Research Network. The primary outcome measure was a three-level outcome - survival without neurodevelopmental impairment, survival with neurodevelopmental impairment, or death. After accounting for differences in infant characteristics, including birth center, we used multinomial generalized logit models to compare the relative risk of survival without neurodevelopmental impairment, survival with neurodevelopmental impairment, and death.ResultsData on the primary outcome were available for 4274 of 4458 infants (96%) born at the 11 centers. The percentage of infants who survived increased from 30% (424 of 1391 infants) in epoch 1 to 36% (487 of 1348 infants) in epoch 3 (P<0.001). The percentage of infants who survived without neurodevelopmental impairment increased from 16% (217 of 1391) in epoch 1 to 20% (276 of 1348) in epoch 3 (P=0.001), whereas the percentage of infants who survived with neurodevelopmental impairment did not change significantly (15% [207 of 1391] in epoch 1 and 16% [211 of 1348] in epoch 3, P=0.29). After adjustment for changes in the baseline characteristics of the infants over time, both the rate of survival with neurodevelopmental impairment (as compared with death) and the rate of survival without neurodevelopmental impairment (as compared with death) increased over time (adjusted relative risks, 1.27 [95% confidence interval {CI}, 1.01 to 1.59] and 1.59 [95% CI, 1.28 to 1.99], respectively).ConclusionsThe rate of survival without neurodevelopmental impairment increased between 2000 and 2011 in this large cohort of periviable infants. (Funded by the National Institutes of Health and others; ClinicalTrials.gov numbers, NCT00063063 and NCT00009633 .).

Project description:BackgroundInflammation may be an important predictor of long-term neurodevelopment in preterm infants. The identification of specific inflammatory biomarkers that predict outcomes is an important research goal.ObjectivesThe purpose of this analysis was to identify associations between an early measure of inflammation and neurodevelopment in very preterm infants and to identify differences in the relationship between inflammation and neurodevelopment based on infant gender and race.MethodsWe conducted a secondary analysis of data from a randomized controlled trial of a caregiving intervention for preterm infants born less than 33 weeks postmenstrual age. Plasma was collected with a clinically indicated laboratory draw by neonatal intensive care unit nurses and analyzed by multiplex assay for cytokines, chemokines, and growth factors. Neurobehavior was assessed by research nurses at the time of discharge from the neonatal intensive care unit using the motor development and vigor and alertness/orientation clusters from the Neurobehavioral Assessment of the Preterm Infant. Neurodevelopment was assessed at 6 months corrected age by the developmental specialist in the hospital's neonatal follow-up clinic using the Bayley Scales of Infant Development, Third Edition. We used linear regressions to estimate the effect of cytokine levels on neurodevelopment and allowed the effects to differ by infant gender and race.ResultsIn a sample of 62 preterm infants with discharge neurobehavioral assessments and a sample of 40 preterm infants with 6-month neurodevelopmental assessments, we found inconsistent associations between single-time point inflammatory measures and neurobehavior or neurodevelopment in analyses of the total sample. However, regressions with interactions revealed effects for multiple inflammatory measures on early neurobehavior and neurodevelopment that differed by infant gender and race.DiscussionAlthough early single-time point measures of inflammation may be insufficient to predict neurodevelopment for all preterm infants, the effect of inflammation appears to differ by infant gender and race. These demographic factors may be important considerations for future studies of inflammation and neurodevelopment as well was the development of future interventions to optimize outcomes.

Project description:Abstract Objectives The association between poor growth and neurodevelopmental impairment (NDI) among preterm infants is well-established whether due to inadequate nutrition, adverse events or both. The present study assessed the diagnostic accuracy of 36-week anthropometric measures, including corresponding < 10th and < 3rd percentile cut points to predict NDI in preterm infants. Methods This study included data from the PreM Growth Cohort Study for preterm infants < 30 weeks of gestational age (GA) and birth weights < 1500 grams. The accuracy with which measured weight, length and head circumference z-scores can predict cognitive impairment (Bayley-III Cognitive Composite score < 80) at 21 months corrected age (born in 2005–2014) and intellectual impairment (Wechsler Preschool and Primary Scale of Intelligence-3rd and 4th Edition (Intellectual test) score < 70) at 3-years corrected age (born in 2001–2014) was determined by the area under the receiver operating characteristic curve (AUROC). Results At 21 months 98/621 (15.8%) of infants had low Bayley scores and 57/613 (9.3%) had low Intellectual test scores at 3 years. None of the AUROCs exceeded 0.6 and none were significantly different from 0.5. Sensitivities and specificities for the 10th and 3rd percentile cut points were equally poor, with most not exceeding 70% (Figures). The findings were similar between the Fenton 2013 and INTERGROWTH 2015 growth charts. The addition of morbidities increased the accuracy of predicting cognitive impairments except for infants with cerebral palsy, other morbidities had relatively marginal associations with impairment. Conclusions Preterm infant measures of weight, length, and head circumference z-scores at 36 weeks, including corresponding < 10th and < 3rd percentile cut points, are not accurate as predictors of NDI. This study confirms previous findings that preterm infants show some “catch up” in weight relative to growth references between 37–44 weeks GA. ClinicalTrials.gov Identifier: NCT03064022 Funding Sources Canadian Foundation for Dietetic Research. Supporting Tables, Images and/or Graphs

Dataset Information

Growth Asymmetry, Head Circumference, and Neurodevelopmental Outcomes in Infants with Single Ventricles.

Publications

Growth Asymmetry, Head Circumference, and Neurodevelopmental Outcomes in Infants with Single Ventricles.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets