Head circumference catch-up growth among preterm very low birth weight infants: effect on neurodevelopmental outcome.

AIMS: The purpose of this study was to determine whether head circumference (HC) catch-up is associated with improved neurocognitive development.

DESIGN: A retrospective cohort study was conducted in 179 preterm very low birth weight (VLBW) (BW≤1500 g) infants. The infants were born in 2000-2002 and were followed to the age of 5.5 years. The association between HC catch-up and neurodevelopmental outcome was assessed and perinatal risk factors, infant characteristics and nutritional practices associated with HC catch-up were determined.

RESULTS: HC catch-up occurred in 59 (34%) infants and was positively correlated with neurodevelopmental outcome. The likelihood of HC catch-up increased with increasing birth weight and gestational age. HC catch-up occurred more often with breast milk feeding during hospitalization and with supplemental formula feeding at discharge, but decreased in prevalence with longer duration of breastfeeding after discharge. HC catch-up was more likely to occur in first-born infants and in families with high socioeconomic status. Most HC catch-up occurred between birth and three months corrected age.

CONCLUSION: Among preterm-VLBW infants, there is a close relation between HC growth and neurodevelopmental outcome. Efforts to improve neurocognitive outcomes should focus on factors associated with HC catch-up.