Macular thickness variation and interocular symmetry by gestational age in preterm school-age children.

PURPOSE: To determine changes in macular thickness profile according to gestational age (GA) and to assess interocular symmetry in the macula of children born very preterm. METHODS: In this cross-sectional study of preterm (n = 106) and term-born (n = 49) children 5-8 years of age at time of examination, optical coherence tomography was used to measure macula thickness as described in the ETDRS study. Statistical analyses included stratified and multivariable analyses. RESULTS: Foveal minimum thickness increased with decreasing GA (P for trend, <0.001; 254.7 ± 32.8 µm for children born at 24-25 weeks and 193.2 ± 32.8 µm in term-born children). Inner and outer area thickness differed for term and preterm children, but did not vary with the degree of prematurity (inner area, 267.0 ± 11.0 µm for 24-25 weeks' GA and 305.4 ± 11.8 µm for term children [P < 0.01]; outer ring, 305.5 ± 10.4 µm in extreme preterm and 271.0 ± 10.4 µm in term children [P < 0.01]). Interocular asymmetry in preterm children was not significant for most areas; the largest interocular difference was found in the central zone (16.3 ±16.6 µm). CONCLUSIONS: In our study cohort, children born very preterm examined at school age compared to term born children had greater central thickness with decreased foveal pit, decreased inner ring, and increased thickness of the outer ring. They did not show greater interocular asymmetry.

Efecto de la velocidad de crecimiento intrahospitalaria en la somatometría a los 2 años en niños con peso de nacimiento menor de 1500 gramos / Effect of intrahospital growth rate on somatometric measurements at 2 years old in children with a birth weight of less than 1500 grams

Objetivo. Determinar la asociación de la velocidad de crecimiento (VC) intrahospitalaria y la fortificación de leche humana con la somatometría y el riesgo de muerte tras el alta o discapacidad grave a los 2 años de edad corregida (EC). Población y método. Análisis retrospectivo de la VC y evolución posterior. Se incluyeron los recién nacidos del período 1990-2015, con peso al nacer < 1500 g. Se excluyeron neonatos con patología que afectaba al crecimiento. Se estudió una cohorte global y dos subcohortes: los nacidos en 1990-2001 (sin fortificación) y los nacidos en 2002-2015 (fortificada). La VC se calculó según la fórmula de Fenton y se consideró adecuada si resultó > 12 g/kg/día. Resultados. Se reclutaron 1194 pacientes. La VC adecuada se asoció a mayor mediana de peso a los 2 años de EC en la cohorte global (11 400 g [10 300-12 500] versus 11 000 g [10 000-12 140], p = 0,02. La cohorte 2002-2015 alcanzó mayor talla media (86,42 ± 4,03 cm versus 85,56 ± 4,01, p = 0,02) y mayor porcentaje de prematuros que alcanzaron un crecimiento compensatorio (catch-up) a los 2 años de EC en la cohorte global con VC adecuada (62,50 % versus 34,69 %, p < 0,02). No se encontraron diferencias en el riesgo de muerte tras el alta o discapacidad grave a los 2 años de EC con VC adecuada (OR: 0,79; IC95 %: 0,47-1,12) ni al considerarse el análisis por subcohortes. Conclusiones. Una VC adecuada se asoció con mejor crecimiento, pero no con menor riesgo de muerte tras el alta o discapacidad grave. La cohorte fortificada alcanzó mayor talla media a los 2 años de EC.

Objective. To determine the association between intrahospital growth rate (GR) and breast milk fortification and somatometry, and risk for death after discharge or severe disability at 2 years of corrected age (CA). Population and method. Retrospective analysis of GR and subsequent course. Infants born in the 1990-2015 period with a birth weight < 1500 g were included. Infants with diseases affecting growth were excluded. An overall cohort and 2 sub-cohorts were studied: infants born in the 1990-2001 period (without fortification) and 2002-2015 period (with fortification). The GR was estimated and deemed adequate if > 12 g/kg/day. Results. A total of 1194 patients were recruited. An adequate GR was associated with a higher median weight at 2 years of CA in the overall cohort (11 400 g [10 300-12 500] versus 11 000 g [10 000-12 140], p = 0.02). The 2002-2015 cohort reached a higher mean height (86.42 ± 4.03 cm versus 85.56 ± 4.01, p = 0.02). More preterm infants caught-up growth at 2 years of CA in the overall cohort with an adequate GR (62.50 % versus 34.69 %, p < 0.02). No differences were observed in the risk for death after discharge or severe disability at 2 years of CA with an adequate GR (OR: 0.79; 95 % confidence interval: 0.47-1.12). Conclusions. An adequate GR was associated with improved growth, but not with a lower risk for death after discharge or severe disability. The cohort with fortified breast milk reached a higher mean height at 2 years of CA

Effect of intrahospital growth rate on somatometric measurements at 2 years old in children with a birth weight of less than 1500 grams. / Efecto de la velocidad de crecimiento intrahospitalaria en la somatometría a los 2 años en niños con peso de nacimiento menor de 1500 gramos.

Objective: To determine the association between intrahospital growth rate (GR) and breast milk fortification and somatometry, and risk for death after discharge or severe disability at 2 years of corrected age (CA). Population and method: Retrospective analysis of GR and subsequent course. Infants born in the 1990-2015 period with a birth weight < 1500 g were included. Infants with diseases affecting growth were excluded. An overall cohort and 2 sub-cohorts were studied: infants born in the 1990-2001 period (without fortification) and 2002-2015 period (with fortification). The GR was estimated and deemed adequate if > 12 g/kg/day. Results: A total of 1194 patients were recruited. An adequate GR was associated with a higher median weight at 2 years of CA in the overall cohort (11 400 g [10 300-12 500] versus 11 000 g [10 000-12 140], p = 0.02). The 2002-2015 cohort reached a higher mean height (86.42 ± 4.03 cm versus 85.56 ± 4.01, p = 0.02). More preterm infants caught-up growth at 2 years of CA in the overall cohort with an adequate GR (62.50 % versus 34.69 %, p < 0.02). No differences were observed in the risk for death after discharge or severe disability at 2 years of CA with an adequate GR (OR: 0.79; 95 % confidence interval: 0.47-1.12). Conclusions: An adequate GR was associated with improved growth, but not with a lower risk for death after discharge or severe disability. The cohort with fortified breast milk reached a higher mean height at 2 years of CA.

Objetivo. Determinar la asociación de la velocidad de crecimiento (VC) intrahospitalaria y la fortificación de leche humana con la somatometría y el riesgo de muerte tras el alta o discapacidad grave a los 2 años de edad corregida (EC). Población y método. Análisis retrospectivo de la VC y evolución posterior. Se incluyeron los recién nacidos del período 1990-2015, con peso al nacer < 1500 g. Se excluyeron neonatos con patología que afectaba al crecimiento. Se estudió una cohorte global y dos subcohortes: los nacidos en 1990-2001 (sin fortificación) y los nacidos en 2002-2015 (fortificada). La VC se calculó según la fórmula de Fenton y se consideró adecuada si resultó > 12 g/kg/día. Resultados. Se reclutaron 1194 pacientes. La VC adecuada se asoció a mayor mediana de peso a los 2 años de EC en la cohorte global (11 400 g [10 300-12 500] versus 11 000 g [10 000-12 140], p = 0,02. La cohorte 2002-2015 alcanzó mayor talla media (86,42 ± 4,03 cm versus 85,56 ± 4,01, p = 0,02) y mayor porcentaje de prematuros que alcanzaron un crecimiento compensatorio (catch-up) a los 2 años de EC en la cohorte global con VC adecuada (62,50 % versus 34,69 %, p < 0,02). No se encontraron diferencias en el riesgo de muerte tras el alta o discapacidad grave a los 2 años de EC con VC adecuada (OR: 0,79; IC95 %: 0,47-1,12) ni al considerarse el análisis por subcohortes. Conclusiones. Una VC adecuada se asoció con mejor crecimiento, pero no con menor riesgo de muerte tras el alta o discapacidad grave. La cohorte fortificada alcanzó mayor talla media a los 2 años de EC.