Longitudinal Analysis of Growth and Neurodevelopmental Outcomes in Very Low Birth Weight Infants With Congenital Anomalies Over Three Years.

Abstract

Background: Very low birth weight infants (VLBWIs) are vulnerable to growth restrictions and neurodevelopmental impairments. Congenital anomalies further complicate these risks; however, their long-term effects remain unclear. This study examined the impact of congenital anomalies on the growth and neurodevelopment of VLBWIs.

Methods: This prospective cohort study analyzed data from the Korean Neonatal Network (2013-2017). A total of 172 VLBWIs with congenital anomalies were matched by gestational age to 516 without anomalies at 18-24 months corrected age, and 136 were matched to 408 at 3 years of age. Growth was assessed using WHO standards, and neurodevelopment was evaluated using the Bayley Scales of Infant Development (II/III) and Korean Developmental Screening Test. Logistic regression analyses were used to identify factors associated with adverse outcomes, with statistical significance set at P < 0.05.

Results: VLBWIs with congenital anomalies had significantly lower weight, height, and head circumference z-scores at both time points. Growth restriction persisted, and neurodevelopmental delays, particularly in motor function, were more prevalent. Infants with multiple congenital anomalies had the highest risk of severe growth restriction and developmental impairment.

Conclusion: Congenital anomalies pose significant challenges to the growth and neurodevelopment of VLBWIs. Early and individualized interventions, structured neurodevelopmental follow-up, and multidisciplinary care are essential for improving long-term outcomes.