RESUMO
AIM: To clarify the influence of intra- and extra-uterine growth on subsequent psychomotor development in very-low-birth-weight (VLBW) infants. METHODS: Two hundred and eighty VLBW infants (28.4⯱â¯2.6â¯weeks, 1000⯱â¯294â¯g) were enrolled. Psychomotor development was determined at 37.1⯱â¯2.1â¯months after birth using the Kyoto Scale of Psychological Development (KSPD), which includes Postural-Motor (P-M), Cognitive-Adaptive (C-A) and Language-Social (L-S) subscales. Subjects were divided into two groups based on whether each developmental quotient (DQ) was ≥85, and the perinatal variables that contributed to a DQ of ≥85 (for each DQ) were determined. The twelve variables that were evaluated included the z scores for body weight (zBW), body length (zBL), head circumference (zHC), which were obtained at birth and at term. RESULTS: The median P-M, C-A, L-S values and total DQ were 92, 83, 81 and 83, respectively, and the percentage of patients with a DQ of ≥85 were 53%, 44%, 35% and 39%, respectively. A multivariate analysis revealed significant associations between the following variables and the DQs: P-Mâ¯≥â¯85, GA [odds ratio; ORâ¯=â¯1.11] and zBL at term [ORâ¯=â¯1.26]; C-Aâ¯≥â¯85, male gender [ORâ¯=â¯0.30], GA [ORâ¯=â¯1.14] and zHC at term [ORâ¯=â¯1.84]; L-Sâ¯≥â¯85, male gender [ORâ¯=â¯0.55], GA [ ORâ¯=â¯1.20] and zHC at term [ORâ¯=â¯1.45]; total DQâ¯≥â¯85, male gender [ORâ¯=â¯0.39], GA [ORâ¯=â¯1.19] and zBL at term [ORâ¯=â¯1.69]. CONCLUSION: In addition to less prematurity and female gender, a longer body length and larger head circumference at term were important indicators that influenced better psychomotor development in VLBW infants at three years of chronological age.