Table 5. Associations of Maternal Milk Intake in the NICU With Neurodevelopmental Outcomes at School Age: Modification by Fetal Growth Statusa.
| Fetal growth status | No. | β (95% CI) | P value for interaction | β (95% CI) | P value for interaction | β (95% CI) | P value for interaction | |
|---|---|---|---|---|---|---|---|---|
| Intelligence (WASI b ) | ||||||||
| Outcome | Full scale | .07 | Verbal | .28 | Performance | .03 | ||
| SGA | 49 | −1.52 (−3.65 to 0.61) | −1.49 (−4.20 to 1.23) | −1.40 (−3.35 to 0.55) | ||||
| Not SGA | 532 | 0.52 (−0.09 to 1.13) | 0.04 (−0.62 to 0.71) | 0.81 (0.22 to 1.39) | ||||
| Academic achievement (WRAT-4 b ) | ||||||||
| Outcome | Reading standard | .79 | Spelling | .19 | Math computation | .24 | ||
| SGA | 49 | 0.73 (−2.34 to 3.81) | −1.12 (−3.75 to 1.51) | −0.70 (−3.22 to 1.81) | ||||
| Not SGA | 525 | 1.15 (0.36 to 1.94) | 0.67 (−0.08 to 1.42) | 0.82 (0.17 to 1.48) | ||||
| Behavior and executive functioning | ||||||||
| Outcome | ADHD symptoms to Conners T score | .77 | Global executive composite to BRIEF | .11 | Total difficulties to SDQ | .38 | ||
| SGA | 49 | −0.65 (−3.65 to 2.34) | 0.99 (−0.84 to 2.82) | 0.24 (−0.84 to 1.31) | ||||
| Not SGA | 526 | −1.12 (−2.03 to −0.21) | −0.52 (−1.20 to 0.16) | −0.25 (−0.59 to 0.08) | ||||
Abbreviations: ADHD, attention-deficit/hyperactivity disorder; BRIEF, Behavior Rating Inventory of Executive Function; NICU, neonatal intensive care unit; SDQ, Strengths and Difficulties Questionnaire; SGA, small for gestational age (birth weight <10th percentile); WASI, Weschler Abbreviated Scale of Intelligence; WRAT-4, Wide Range Achievement Test, Fourth Edition.
The β estimates indicate points per 25 mL/kg daily of additional maternal milk intake in the NICU. P values are for the interaction of SGA category. All estimates are adjusted for treatment, center, maternal tertiary education, maternal occupation, number of adults and children in the home, maternal smoking in pregnancy, parity, race, and antenatal steroid exposure. Generalized estimating equations were used to account for clustering for multiple gestation. Sample size may be slightly different across subscales.
Higher scores on the WASI and WRAT-4 indicate more favorable outcomes, whereas lower score on the Conners Third Edition ADHD Index, BRIEF, and SDQ total difficulties indicate more favorable outcomes.