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Reduced calf muscle growth in NICU graduates compared with typically developing term infants: 12-month longitudinal study of infant muscle growth
  1. Sian A Williams1,2,
  2. Malcolm Battin3,
  3. Alana Cavadino4,
  4. Ali Mirjalili5,
  5. Louise Pearce6,
  6. Amy Mulqueeney7,
  7. Ngaire Susan Stott8
  1. 1Curtin University, Perth, Western Australia, Australia
  2. 2Liggins Institute, The University of Auckland, Auckland, New Zealand
  3. 3Auckland City Hospital, Auckland, New Zealand
  4. 4Department of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
  5. 5The University of Auckland, Auckland, New Zealand
  6. 6Auckland Children’s Physiotherapy, Auckland, New Zealand
  7. 7Newborn Services, Starship Child Health, Auckland District Health Board, Auckland, New Zealand
  8. 8Orthopaedic Surgery, Auckland City Hospital, Auckland, New Zealand
  1. Correspondence to Dr Sian A Williams; sian.williams{at}curtin.edu.au

Abstract

Objective To evaluate growth of the triceps surae muscle over the first 12 months of life in neonatal intensive care unit (NICU) graduates compared with typically developing (TD) infants.

Design Longitudinal, prospective study.

Participants Sixty-one infants, n=24 TD (15 male) and n=37 NICU graduates designated as intermediate-risk (NICU-IR; n=14, 9 male) or higher-risk (NICU-HR; n=23, 11 male) based on additional risk factors (including <28 weeks gestational age; <1000 g; neonatal encephalopathy; abnormal neuroimaging; small for gestational age).

Outcome measures Sequential assessments at corrected ages 3, 6 and 12 months of muscle volume (freehand three-dimensional ultrasound) and gross motor development (Peabody Developmental Motor Scale-2, Gross Motor Quotient (GMQ)). Linear mixed models analysed muscle volume trajectories.

Results Triceps surae growth trajectories differed significantly by group (p<0.001). Between 3 and 12 months, triceps surae increased on average by 18.1 cm3 (95% CI 16.1 to 20.2 cm3), 13.3 cm3 (10.6 to 16.0 cm3) and 12.5 cm3 (10.5 to 14.6 cm3) in TD, NICU-IR and NICU-HR infants, respectively. Soleus was significantly smaller at 6 and 12 months for both NICU groups, and lateral gastrocnemius was smaller at 12 months for NICU-HR (p<0.001). At 12 months of age, 8% of NICU infants and 30% of the TD infants were walking, the GMQ was >90 in all TD infants, and all but 5 (14%) NICU infants. Muscle volumes at 12 months were positively associated with both gestational age and birth weight.

Conclusion Reduced soleus growth from 3 to 12 months led to a 25% smaller triceps surae muscle at 12 months in NICU graduates.

  • neonatology
  • paediatrics
  • intensive care units, neonatal
  • infant development

Data availability statement

Data are available on reasonable request. The data that support the findings of this study are available from the corresponding author on reasonable request.

https://doi.org/10.1136/archdischild-2024-328402

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    Data availability statement

    Data are available on reasonable request. The data that support the findings of this study are available from the corresponding author on reasonable request.

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    Footnotes

    • X @WilliamsSianA

    • Contributors All authors approved the final text and had final responsibility for the decision to submit the manuscript for publication. SAW, MB, NSS and AMi were responsible for conceptualisation, methodology and securing funding. NSS and MB provided project supervision. SAW, LP and AMu were responsible for investigation, with SAW also overseeing project administration. AC was responsible for statistical analysis and data visualisation. SAW and NSS were responsible for drafting both the initial and final versions of the manuscript. All authors contributed to reviewing and editing the final manuscript. SAW is the guarantor and takes overall responsibility for the content.

    • Funding Funding support from the Auckland Academic Health Alliance Grant and the Auckland Medical Research Foundation Grant (number: 1118015) contributed to the operational costs of the study, including research assistants, physiotherapy assessor time, consumables and biostatistical support, as well as part of SAW’s salary. Additional salary support for SAW was provided by the Aotearoa Foundation and the Australasian Cerebral Palsy Clinical Trials Network, a Centre for Research Excellence funded by the National Health and Medical Research Council (Australia).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.