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Neonatal Follow-up

NICU Follow Up and Neurodevelopmental 2: Neonatal Growth, Nutrition and the Brain

206 - Neonatal Body Composition After Discharge and Neurodevelopmental Outcomes

Friday, April 28, 2023

5:15 PM – 7:15 PM ET

Poster Number: 206
Publication Number: 206.144

Laura Lach, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Katherine E. Chetta, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Mathew J. Gregoski, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Lakshmi D. Katikaneni, Medical University of South Carolina College of Medicine, Charleston, SC, United States

Presenting Author(s)

Laura Lach, DO

Fellow Physician
Medical University of South Carolina College of Medicine
Charleston, South Carolina, United States

Background: Growth and body composition metrics of preterm infants have been associated with improved neurodevelopmental outcomes. By term-equivalent age, preterm infants have more body fat and less lean mass than term infants. Little is known about the body composition of preterm infants after discharge. Studies show fat-free mass and fat mass gain, as well as mother’s own milk benefit neurodevelopment. Early accumulation of fat may be beneficial short term yet may be implicated in later metabolic disease.

Objective: To associate body composition measured by air plethysmography (ADP) at two timepoints, 35-40 weeks postmenstrual age (PMA) and 48-58 weeks PMA, with neonatal factors and neurodevelopmental testing at 4-6 months corrected age. We hypothesized that increased fat free mass would be positively associated neurodevelopment scores (CAT/CLAMS, Peabody Gross Motor testing).

Design/Methods: From 2007-2011, 510 infants admitted to Medical University of South Carolina’s NICU underwent ADP (PeaPod) as part of clinical care. A total of 379 of 510 (74%) had anthropometrics at birth and ADP scan with fat free mass, fat mass, fat percent z-scores per Norris et al growth reference charts and neurodevelopmental evaluation (CAT/CLAMS, Peabody Gross Motor). Variables were compared using univariate and multivariate analysis for each body composition measurement. Variables were chosen systematically for inclusion in a stepwise regression model. Statistical significance defined as (p< 0.05) analyzed with SPSS (V 28).

Results:

Infants were 31±4 weeks gestation at birth. At 35-40 weeks PMA, fat mass is associated with maternal diabetes (p=0.003) and SGA status is associated with fat and fat free mass (p=0.001). At 48-58 weeks PMA, fat free mass and fat mass are associated with birth length z-score (p< 0.001). At both timepoints, fat free mass was positively correlated to both neurodevelopmental cognitive (CAT) testing, language (CLAMS) and gross motor testing. When including ADP at 48-58 weeks in the model, breast milk feeding at discharge correlated to improved cognitive and language testing (p< 0.05).

Conclusion(s): Body composition after discharge, mother’s own milk intake and neonatal factors influence neurodevelopment.