Postnatal weight increase and growth velocity of very low birthweight infants
E Bertino1, A Coscia, M Mombrò
1Cattedra di Neonatologia, Dipartimento di Scienze Pediatriche e dell'Adolescenza, Università di Torino, Via Ventimiglia 3, 10126 Torino, Italy. enrico.bertino@unito.it
Insights
Postnatal growth in very low birthweight (VLBW) infants shows two peaks, but those with morbidities or small for gestational age experience impaired growth. This study analyzes VLBW infant growth kinetics up to two years.
Area of Science:
- Neonatalogy
- Pediatric Growth and Development
- Biostatistics
Background:
- Limited research exists on postnatal growth velocity in very low birthweight (VLBW) infants.
- Understanding VLBW infant growth patterns is crucial for optimizing care.
Purpose of the Study:
- To analyze the weight growth kinetics of very low birthweight (VLBW) infants from birth to over two years of age.
- To establish a growth model for VLBW infants.
Main Methods:
- 262 VLBW infants were studied, excluding those with major congenital anomalies, necrotising enterocolitis, or significant loss to follow-up.
- Weight was recorded frequently from birth through 24 months corrected age.
- Individual growth profiles were modeled using a seven-constant exponential-logistic function.
Main Results:
- VLBW infants exhibited an early (2-6 weeks) and a late (7-21 weeks) neonatal peak in growth velocity after initial weight loss.
- Infants who were small for gestational age or had major morbidities showed reduced growth compared to reference VLBW infants.
- At 2 years, weight differences reached approximately 860g, primarily due to diminished late neonatal peak height in infants with morbidities.
Conclusions:
- The developed growth model can assess the impact of pathological conditions and care protocols on VLBW infant growth kinetics.
- This model provides a tool for evaluating interventions aimed at improving VLBW infant growth outcomes.
Background:
Only a few studies have dealt with postnatal growth velocity of very low birthweight (VLBW) infants.
Objective:
To analyse weight growth kinetics of VLBW infants from birth to over 2 years of age.
Patients:
A total of 262 VLBW infants were selected; inaccurate estimate of gestational age, major congenital anomalies, necrotising enterocolitis, death, and loss to follow up within the first year were the exclusion criteria.
Methods:
Body weight was recorded daily up to 28 days or up to discontinuation of parenteral nutrition, weekly up to discharge, then at 1, 3, 6, 9, 12, 18, and 24 months of corrected age. Individual growth profiles were fitted with a seven constant, exponential-logistic function suitable for modelling weight loss and weight recovery, two peaks, and the subsequent slow decrease in growth velocity.
Results:
After a postnatal weight loss, all infants showed a late neonatal peak of growth velocity between the 7th and 21st weeks; most also experienced an early neonatal peak between the 2nd and 6th week. VLBW infants who were small for gestational age and those with major morbidities grew less than reference VLBW infants who were the appropriate size for gestational age without major morbidities: at 2 years of age, the difference in weight was about 860 g. The more severe growth impairment seen in VLBW infants with major morbidities is almost entirely due to the reduced height of the late neonatal peak of velocity.
Conclusions:
The growth model presented here should be a useful tool for evaluating to what extent different pathological conditions or nutritional and medical care protocols affect growth kinetics.
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