Publication:
Association between Preterm-Birth Phenotypes and Differential Morbidity, Growth, and Neurodevelopment at Age 2 Years: Results from the INTERBIO-21st Newborn Study

Issued Date

2021-05-01

Resource Type

Article

ISSN

21686211
21686203

DOI

10.1001/jamapediatrics.2020.6087

Other identifier(s)

2-s2.0-85101738023

Rights

Mahidol University

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SCOPUS

Bibliographic Citation

JAMA Pediatrics. Vol.175, No.5 (2021), 483-493

Suggested Citation

Jose Villar, María C. Restrepo-Méndez, Rose McGready, Fernando C. Barros, Cesar G. Victora, Shama Munim, Aris T. Papageorghiou, Roseline Ochieng, Rachel Craik, Hellen C. Barsosio, James A. Berkley, Maria Carvalho, Michelle Fernandes, Leila Cheikh Ismail, Ann Lambert, Shane A. Norris, Eric O. Ohuma, Alan Stein, Chrystelle O.O. Tshivuila-Matala, Krina T. Zondervan, Adele Winsey, Francois Nosten, Ricardo Uauy, Zulfiqar A. Bhutta, Stephen H. Kennedy Association between Preterm-Birth Phenotypes and Differential Morbidity, Growth, and Neurodevelopment at Age 2 Years: Results from the INTERBIO-21st Newborn Study. JAMA Pediatrics. Vol.175, No.5 (2021), 483-493. doi:10.1001/jamapediatrics.2020.6087 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78264

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Title

Association between Preterm-Birth Phenotypes and Differential Morbidity, Growth, and Neurodevelopment at Age 2 Years: Results from the INTERBIO-21st Newborn Study

Author(s)

Jose Villar
 María C. Restrepo-Méndez
 Rose McGready
 Fernando C. Barros
 Cesar G. Victora
 Shama Munim
 Aris T. Papageorghiou
 Roseline Ochieng
 Rachel Craik
 Hellen C. Barsosio
 James A. Berkley
 Maria Carvalho
 Michelle Fernandes
 Leila Cheikh Ismail
 Ann Lambert
 Shane A. Norris
 Eric O. Ohuma
 Alan Stein
 Chrystelle O.O. Tshivuila-Matala
 Krina T. Zondervan
 Adele Winsey
 Francois Nosten
 Ricardo Uauy
 Zulfiqar A. Bhutta
 Stephen H. Kennedy

Other Contributor(s)

Faculty of Tropical Medicine, Mahidol University
 The Wellcome Centre for Human Genetics
 University of Sharjah
 Wellcome Trust Research Laboratories Nairobi
 Aga Khan Hospital Nairobi
 The Aga Khan University
 London School of Hygiene & Tropical Medicine
 Hospital for Sick Children University of Toronto
 Green Templeton College
 University of Oxford
 University of Southampton, Faculty of Medicine
 Universidade Catolica de Pelotas
 Liverpool School of Tropical Medicine
 The World Bank Group
 University of the Witwatersrand, Johannesburg
 Universidade Federal de Pelotas
 Wits School of Public Health
 Nuffield Department of Medicine
 University of Oxford Medical Sciences Division

Abstract

Importance: The etiologic complexities of preterm birth remain inadequately understood, which may impede the development of better preventative and treatment measures. Objective: To examine the association between specific preterm-birth phenotypes and clinical, growth, and neurodevelopmental differences among preterm newborns compared with term newborns up to age 2 years. Design, Setting, and Participants: The INTERBIO-21st study included a cohort of preterm and term newborn singletons enrolled between March 2012 and June 2018 from maternity hospitals in 6 countries worldwide who were followed up from birth to age 2 years. All pregnancies were dated by ultrasonography. Data were analyzed from November 2019 to October 2020. Exposures/Interventions: Preterm-birth phenotypes. Main Outcomes and Measures: Infant size, health, nutrition, and World Health Organization motor development milestones assessed at ages 1 and 2 years; neurodevelopment evaluated at age 2 years using the INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA) tool. Results: A total of 6529 infants (3312 boys [50.7%]) were included in the analysis. Of those, 1381 were preterm births (mean [SD] gestational age at birth, 34.4 [0.1] weeks; 5148 were term births (mean [SD] gestational age at birth, 39.4 [0] weeks). Among 1381 preterm newborns, 8 phenotypes were identified: no main maternal, fetal, or placental condition detected (485 infants [35.1%]); infections (289 infants [20.9%]); preeclampsia (162 infants [11.7%]); fetal distress (131 infants [9.5%]); intrauterine growth restriction (110 infants [8.0%]); severe maternal disease (85 infants [6.2%]); bleeding (71 infants [5.1%]); and congenital anomaly (48 infants [3.5%]). For all phenotypes, a previous preterm birth was a risk factor for recurrence. Each phenotype displayed differences in neonatal morbidity and infant outcomes. For example, infants with the no main condition detected phenotype had low neonatal morbidity but increased morbidity and hospitalization incidence at age 1 year (odds ratio [OR], 2.2; 95% CI, 1.8-2.7). Compared with term newborns, the highest risk of scoring lower than the 10th centile of INTER-NDA normative values was observed in the fine motor development domain among newborns with the fetal distress (OR, 10.6; 95% CI, 5.1-22.2) phenotype. Conclusions and Relevance: Results of this study suggest that phenotypic classification may provide a better understanding of the etiologic factors and mechanisms associated with preterm birth than continuing to consider it an exclusively time-based entity..

Keyword(s)

Medicine

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https://repository.li.mahidol.ac.th/handle/20.500.14594/78264

Collections

Scopus 2021