Postnatal growth failure in very low birthweight infants born between 2005 and 2012

BackgroundPostnatal growth restriction is common in preterm infants and is associated with long-term neurodevelopmental impairment. Recent trends in postnatal growth restriction are unclear.MethodsBirth and discharge weights from 25 899 Californian very low birthweight infants (birth weight 500–1500...

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Veröffentlicht in:Archives of disease in childhood. Fetal and neonatal edition Jg. 101; H. 1; S. 50 - 55
Hauptverfasser: Griffin, Ian J, Tancredi, Daniel J, Bertino, Enrico, Lee, Henry C, Profit, Jochen
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England BMJ Publishing Group LTD 01.01.2016
Schlagworte:
Age
Babies
Birth Weight
Body Weight
California
Child Development
Comorbidity
Female
Gender
Gestational Age
Hospitals
Humans
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight - growth & development
Infants
Lung diseases
Male
Nutrition
Premature birth
Risk factors
Sepsis
Variables
California
United States > US
Neonatology
Outcomes research
Growth
ISSN:1359-2998, 1468-2052, 1468-2052
Online-Zugang:Volltext
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Zusammenfassung:BackgroundPostnatal growth restriction is common in preterm infants and is associated with long-term neurodevelopmental impairment. Recent trends in postnatal growth restriction are unclear.MethodsBirth and discharge weights from 25 899 Californian very low birthweight infants (birth weight 500–1500 g, gestational age 22–32 weeks) who were born between 2005 and 2012 were converted to age-specific Z-scores and analysed using multivariable modelling.ResultsBirthweight Z-score did not change between 2005 and 2012. However, the adjusted discharge weight Z-score increased significantly by 0.168 Z-scores (0.154, 0.182) over the study period, and the adjusted fall in weight Z-score between birth and discharge decreased significantly between those dates (by 0.016 Z-scores/year). The proportion of infants who were discharged home below the 10th weight-for-age centile or had a fall in weight Z-score between birth and discharge of >1 decreased significantly over time. The comorbidities most associated with poorer postnatal growth were medical or surgical necrotising enterocolitis, isolated gastrointestinal perforation and severe retinopathy of prematurity, which were associated with an adjusted mean reduction in discharge weight Z-score of 0.24, 0.57, 0.46 and 0.32, respectively. Chronic lung disease was not a risk factor after accounting for length of stay.ConclusionsPostnatal, but not prenatal, growth improved among very low birthweight infants between 2005 and 2012. Neonatal morbidities including necrotising enterocolitis, gastrointestinal perforations and severe retinopathy of prematurity have significant negative effects on postnatal growth.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:1359-2998
1468-2052
1468-2052
DOI:10.1136/archdischild-2014-308095