Published online September 1, 2008
PEDIATRICS Vol. 122 No. 3 September 2008, pp. e689-e695 (doi:10.1542/peds.2008-0500)
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ARTICLE

Infant Growth and Child Cognition at 3 Years of Age

Mandy B. Belfort, MD, MPHa, Sheryl L. Rifas-Shiman, MPHb, Janet W. Rich-Edwards, ScDc,d, Ken P. Kleinman, ScDb, Emily Oken, MD, MPHb and Matthew W. Gillman, MD, SMb,e

a Division of Newborn Medicine, Children's Hospital, Boston, Massachusetts
b Obesity Prevention Program, Department of Ambulatory Care and Prevention, Harvard Medical School/Harvard Pilgrim Health Care, Boston, Massachusetts
c Division of Women's Health, Brigham and Women's Hospital, Boston, Massachusetts
d Departments of Epidemiology
e Nutrition, Harvard School of Public Health, Boston, Massachusetts

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.

Key Words: infant growth • neurodevelopment

Abbreviations: FTT—failure to thrive • PPVT-III—Peabody Picture Vocabulary Test III • WRAVMA—Wide Range Assessment of Visual Motor Abilities • CI—confidence interval

Accepted Apr 16, 2008.


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