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Published on: June 29, 2013
Extrauterine growth restriction: a continuing problem in the NICU
Catherine R Coverston1, Rosanne Schwartz
1College of Nursing, Brigham Young University, Utah, USA. cc24@email.byu.edu
Insights
Extrauterine growth restriction (EGR) signifies severe infant malnutrition. Identifying and managing EGR in preterm infants is crucial for improving growth outcomes and preventing long-term complications.
Area of Science:
- Neonatalogy
- Pediatric Nutrition
- Growth Monitoring
Background:
- Extrauterine growth restriction (EGR) is a key indicator of significant nutritional deficits in early neonatal life.
- Infants with EGR exhibit growth below the 10th percentile of expected intrauterine growth, based on gestational age.
- Preterm infants, especially those weighing less than 1500g at birth, face the highest risk of developing EGR.
Purpose of the Study:
- To highlight the critical need for increased awareness and proactive management of EGR in neonatal intensive care units (NICUs).
- To emphasize the importance of implementing systematic assessment protocols for early identification of EGR.
- To explore strategies for reducing energy expenditure and enhancing nutritional support for very low birth weight (VLBW) infants.
Main Methods:
- Review of existing literature and clinical guidelines on EGR in preterm infants.
- Analysis of risk factors associated with EGR, including gestational age and birth weight.
- Discussion of current and innovative nutritional management strategies in the NICU setting.
Main Results:
- The incidence of EGR escalates with decreasing estimated gestational age and birth weight.
- Lower birth weight correlates with a prolonged period of initial weight loss, exacerbating growth challenges.
- Effective nutritional management is essential to mitigate the adverse effects of EGR.
Conclusions:
- NICU caregivers must enhance their understanding of EGR and its implications.
- Implementing structured assessment tools and targeted nutritional interventions can significantly reduce EGR incidence and severity.
- Innovative nutritional management is vital for improving the growth trajectory and long-term health of VLBW infants.
Abstract:
Extrauterine growth restriction (EGR) is an identifiable marker of severe nutritional deficit during the first weeks of life. Infants with EGR have growth values at or below the 10th percentile of intrauterine growth expectation based on estimated gestational age. Although all preterm sick infants are at risk for EGR, risk is greatest for those infants <1500 g at birth. As estimated gestational age and birthweight decrease, the incidence of extrauterine growth restriction increases. The duration of initial weight loss also increases as birthweight decreases, compounding the difficulty of attaining appropriate growth. To decrease the incidence and consequences of nutritional deficit, NICU caregivers should learn more about EGR, implement assessment protocols to identify EGR, seek opportunities to decrease energy needs of at-risk infants, and work toward enhancing nutritional status of VLBW infants through innovative nutritional management.
