The association between the tendency of the head circumference growth trajectory in neonates (1 month) and the psychomotor development of extremely preterm infants at the age of 3 years

Abstract

Aim: to study the association of the head circumference (HC) growth trajectory in extremely preterm neonates (1 month) with the outcomes of psychomotor development by the age of 3 years. Patients and Methods: a retrospective cohort study included 140 children with extremely low birth weight in the Yaroslavl region in the period from 2012 to 2018 and observed up to the age of 3 in the outpatient department for infants of the Regional Perinatal Center. The HC growth trajectory was determined based on the tendency of indicators from the birth to the age of 1 month, expressed as a percentage. The Clinical Adaptive Test / Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS) was used to assess psychomotor development. The outcomes of psychomotor development were defined as the norm, development dissociation (differences in indicators of the CAT/CLAMS and motor skills) and delayed development. Results: the tendency of the HC growth in neonates (1 month) was characterized by three trajectories: slow growth (n=37; 26.4%), catch-up growth (n=69; 49.3%) and rapid catch-up growth (n=34; 24.3%) with significant differences in indicators of psychomotor development at the age of 3 years (p<0.001). More than half (52.9%) of extremely preterm infants with rapid catch-up growth of HC had normal psychomotor development, while in the group with HC delayed growth — only 24.3%. The HC growth trajectory in neonates (1 month) and the outcomes of psychomotor development of children by the age of 3 were influenced by the following: gestational age, birth weight, HC at birth, ventilator length of stay, the presence of bronchopulmonary dysplasia, hemodynamically significant persistent ductus arteriosus, postnatal growth retardation and the method of feeding. Conclusion: extremely preterm neonates (1 month) with HC slow growth are subject to a delay in psychomotor development by the age of 3 years. KEYWORDS: children, preterm infants, head circumference, head circumference growth trajectory, psychomotor development, CAT/CLAMS. FOR CITATION: Shcherbakova V.P., Mozzhukhina L.I., Stroyeva L.E. et al. The association between the tendency of the head circumference growth trajectory in neonates (1 month) and the psychomotor development of extremely preterm infants at the age of 3 years. Russian Journal of Woman and Child Health. 2023;6(2):157–163 (in Russ.). DOI: 10.32364/2618-8430-2023-6-2-157-163.