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[Postnatal growth delay in 27 to 33 week premature infants: frequency and risk factors. Retrospective study of 161
V Mucignat1, I De Montgolfier-Aubron, C Grillon
1Service de néonatologie, hôpital Armand-Trousseau, AP-HP, 26, avenue du Dr Arnold-Netter, 77571 cedex 12, Paris, France. v.mucignat@trs.ap-hop-paris.fr <v.mucignat@trs.ap-hop-paris.fr>
Insights
Half of premature infants appropriate for gestational age experienced postnatal hypotrophy. Key risk factors identified include low birth weight, low gestational age, and nosocomial infections, highlighting the need for optimized nutrition and infection control in neonatal care.
Area of Science:
- Neonatalogy
- Pediatric Nutrition
- Growth and Development
Context:
- Improving survival rates in very low birth weight premature neonates necessitates optimizing their nutrition for growth comparable to in utero development.
- Premature neonates with birth weight appropriate for gestational age are a focus for understanding growth challenges.
Purpose:
- To analyze anthropometric data at birth and near term in premature neonates.
- To identify risk factors associated with postnatal hypotrophy in this cohort.
Summary:
- A retrospective study included 161 premature neonates (gestational age < 33 weeks, appropriate for gestational age).
- Eighty-two neonates (51%) exhibited postnatal hypotrophy (PNH) at discharge.
- Multivariate analysis identified low birth weight, low gestational age, and nosocomial infection as significant risk factors for PNH.
Impact:
- Findings indicate that suboptimal nutrition and intercurrent factors like nosocomial infections significantly contribute to hypotrophy in premature neonates.
- This study underscores the critical need for enhanced nutritional strategies and infection prevention in neonatal intensive care units.
Unlabelled:
The optimization of the nutrition of very low birth weight premature neonates has become a major concern given the improvement in survival for these children. The goal of the recommended nutritional intakes is to reach a quantitative and qualitative growth similar to the in utero growth. The objectives of this study were to analyze the anthropometric data at birth and near term in a cohort of premature neonates with birth weight appropriate for gestational age and to try to determine risk factors of postnatal hypotrophy.
Population And Methods:
We conducted a retrospective study over three years (1998-2001) in the neonatology unit of the Armand Trousseau Children's Hospital, Paris, France. The inclusion criteria was a gestational age under 33 weeks with birth weight appropriate for gestational age. Data were collected at admission, during hospitalisation and at discharge and a standardised form was filled for each child. We defined postnatal hypotrophy (PNH) as an hypotrophy at discharge (weight < 10(th) centile according to the Audipog reference curve) in neonates with birth weight appropriate for gestational age.
Results:
One hundred and sixty one neonates were included. Eighty two had PNH. In univariate analysis, factors significantly associated with PNH were: birth weight, gestational age, length of hospitalisation, the occurrence of nosocomial infection, of enteropathy, preeclampsia, neonatal asphyxia and antenatal corticoid treatment. In multivariate analysis, risk factors of PNH were: low birth weight, low gestational age and the occurrence of nosocomial infection.
Conclusion:
Our study shows that half of the appropriate for gestational age premature neonates were hypotrophic near term. The causes may be various: nutrition is not optimal and intercurrent factors may play a major role such as nosocomial infection.
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