Neurodevelopmental Outcomes in Postnatal Growth-Restricted Preterm Infants with Postnatal Head-Sparing

OBJECTIVE: To compare neurodevelopmental outcomes in postnatal growth-restricted infants born < 29 weeks with and without postnatal head-sparing. STUDY DESIGN: We analyzed developmental outcomes at 2 years of age among postnatally growth-restricted infants with and without head-sparing. The primary outcome was Bayley III cognitive composite score; secondary outcomes included Bayley III motor composite score, moderate/severe cerebral palsy, GMFCS level ≥2, and presence or absence of neurodevelopmental impairment (NDI). RESULTS: Of 1098 infants evaluated at 18–22 months, 658 were postnatally growth-restricted, of whom 301 had head-sparing. In the multivariate model including independent risk factors for poor growth and poor developmental outcome, infants with head-sparing had higher adjusted motor composite scores (mean difference 4.65, p<0.01), but no differences in other neurodevelopmental outcomes. CONCLUSION: Postnatal head-sparing is associated with improved neurodevelopmental outcome in extremely preterm infants, specifically Bayley III motor scores, but whether beneficial effects of PHS persist later in life is unknown.