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Published on: June 29, 2013
Prediction of extrauterine growth retardation (EUGR) in VVLBW infants
Paula G Radmacher1, Stephen W Looney, Salisa T Rafail
1Department of Pediatrics, University of Louisville School of Medicine, Louisville, KY 40292, USA.
Insights
Extrauterine growth retardation (EUGR) is common in very very low birth weight (VVLBW) infants. Birth weight percentile and days of total parenteral nutrition predict EUGR in these vulnerable infants.
Area of Science:
- Neonatalogy
- Pediatric Nutrition
- Growth and Development
Background:
- Long-term growth failure is a frequent complication in very very low birth weight (VVLBW) infants due to extreme prematurity.
- Critical illnesses in premature infants pose significant challenges to achieving adequate nutritional support.
Purpose of the Study:
- Identify predictors of extrauterine growth retardation (EUGR) in VVLBW infants.
- Evaluate nutritional intake and subsequent growth patterns in this population.
Main Methods:
- Retrospective chart review of 221 VVLBW infants (<1000 g birth weight, <29 weeks gestational age).
- Data collected included daily nutritional intake, anthropometric measurements, and significant clinical events.
- Analysis focused on identifying predictors of EUGR, considering birth weight (BW) percentile, parenteral nutrition duration, and head circumference (HC) percentile.
Main Results:
- Mean energy and protein intakes during hospitalization fell below recommended levels.
- In utero growth rates were not consistently achieved or sustained postnatally.
- Birth weight percentile was a strong predictor of EUGR (p<0.001).
- Days of total parenteral nutrition (p<0.001) and HC percentile at return to birth weight (p<0.001) were significant independent predictors of EUGR after accounting for BW.
Conclusions:
- Nutritional intake in hospitalized VVLBW infants often remains suboptimal.
- Birth weight percentile, duration of total parenteral nutrition, and head circumference percentile are key predictors of EUGR.
- Targeted nutritional interventions and close monitoring of growth parameters are crucial for improving outcomes in VVLBW infants.
Background:
Long-term growth failure in very very low birth weight (VVLBW) infants is a common complication of extreme prematurity. Critical illnesses create challenges to adequate nutriture.
Purpose:
To identify predictors of extrauterine growth retardation (EUGR) in VVLBW infants and to evaluate their nutritional intake and subsequent growth.
Study Design:
A 4-year retrospective chart review of 221 infants
Results:
Mean energy and protein intakes during hospitalization did not reach recommendations of 120 kcal/kg/d and 3.0 g/kg/day. In utero growth rates could not be consistently reached or sustained. As expected, BW (as measured by BW percentile score) was highly predictive of EUGR (p<0.001). When the independent effect of other predictors of EUGR was considered, only days of total parenteral nutrition (p<0.001) and HC percentile at return to birth weight (p<0.001) made a significant contribution to the prediction of EUGR, once the effect of BW was taken into account.
