Infant growth and child cognition at 3 years of age.

Belfort MB, Rifas-Shiman SL, Rich-Edwards JW, Kleinman KP, Oken E, Gillman MW.

Children's Hospital Boston, Division of Newborn Medicine, Hunnewell 437, 300 Longwood Ave, Boston, MA 02115, USA. mandy.belfort@childrens.harvard.edu

Pediatrics. 2008 Sep;122(3):e689-95.

BACKGROUND: Infancy is a critical period for brain development. Few studies have examined the extent to which infant weight gain is associated with later neurodevelopmental outcomes in healthy populations. OBJECTIVE: The purpose of this work was to examine associations of infant weight gain from birth to 6 months with child cognitive and visual-motor skills at 3 years of age. PATIENTS AND METHODS: We studied 872 participants in Project Viva, an ongoing prospective, longitudinal, prebirth cohort. We abstracted birth weight from the medical chart and weighed infants at 6 months of age. We used the 2000 Centers for Disease Control and Prevention growth charts to derive weight-for-age z scores. Our primary predictor was infant weight gain, defined as the weight-for-age z score at 6 months adjusted for the weight-for-age z score at birth. At 3 years of age, we measured child cognition with the Peabody Picture Vocabulary Test III and visual-motor skills with the Wide Range Assessment of Visual Motor Abilities. RESULTS: Mean Peabody Picture Vocabulary Test III score was 104.2, and mean Wide Range Assessment of Visual Motor Abilities test score was 102.8. Mean birth weight z score was 0.21, and mean 6-month weight z score was 0.39. In multiple linear regression adjusted for child age, gender, gestational age, breastfeeding duration, primary language, and race/ethnicity; maternal age, parity, smoking status, and cognition; and parental education and income level, we found no association of infant weight gain with child Peabody Picture Vocabulary Test III score (-0.4 points per z score weight gain increment, 95% confidence interval -1.3, 0.6) or total Wide Range Assessment of Visual Motor Abilities standard score (-0.4 points, 95% confidence interval -1.2, 0.5). CONCLUSIONS: Slower infant weight gain was not associated with poorer neurodevelopmental outcomes in healthy, term-born 3-year-old children. These results should aid in determining optimal growth patterns in infants to balance risks and benefits of health outcomes through the life course.

PMID: 18762504 [PubMed - in process]

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