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Published on: June 29, 2013
Extrauterine growth restriction in preterm infants of gestational age < or =32 weeks
Motoichiro Sakurai1, Kazuo Itabashi, Yuko Sato
1Department of Pediatrics, Showa University School of Medicine, Tokyo, Japan. kii0124@yahoo.co.jp
Insights
Extrauterine growth restriction (EUGR) affects low-birthweight (LBW) infants. Key factors include lower gestational age and delayed feeding, impacting weight, length, and head circumference. Addressing these is crucial for infant development.
Area of Science:
- Neonatalogy
- Pediatric Growth and Development
Background:
- Extrauterine growth restriction (EUGR) in low-birthweight (LBW) infants impacts long-term health and development.
- Understanding EUGR in infants born at or after 32 weeks gestational age is critical.
Purpose of the Study:
- To determine the frequency of EUGR in infants born at or after 32 weeks gestational age.
- To identify factors contributing to EUGR in this population.
Main Methods:
- Study included 416 infants (gestational age ≥32 weeks) from 22 facilities.
- EUGR was defined as body measurements below the 10th percentile at 37-42 weeks postmenstrual age (PMA).
Main Results:
- High incidence rates for EUGR: 57% for weight, 49% for length, 6% for head circumference.
- Lower gestational age and delayed complete feeding were associated with increased EUGR for weight, length, and head circumference.
- Small-for-gestational-age status, oxygen use at 36 weeks PMA, and delayed breastfeeding initiation were significant factors for weight and length EUGR.
Conclusions:
- Growth retardation in preterm LBW infants within neonatal intensive care units remains a significant challenge.
- Factors beyond gestational age, including intrauterine growth restriction, chronic lung disease, and nutrition, contribute to EUGR.
Background:
Extrauterine growth restriction (EUGR) in low-birthweight (LBW) infants affects their growth and developmental prognoses as well as their incidence of adult diseases. The aim of the present paper was to determine the frequency and contributing factors of EUGR in infants > or =32 weeks of gestational age.
Methods:
The subjects consisted of 416 infants from 22 facilities born between February and October 2002, whose gestational age was > or =32 weeks. For EUGR assessment, subjects whose body measurements in the 37-42 week postmenstrual age (PMA) period were below the 10th percentile of the standard normal distribution, were selected.
Results:
EUGR incidence rates for weight, length, and head circumference were 57%, 49%, and 6%. In appropriate-for-gestational-age infants, a negative correlation was found between number of gestational weeks and EUGR incidence rates for weight, length, and head circumference, but in small-for-gestational-age infants this was true only for head circumference. Lower gestational age and age in days to achieve complete feeding were among the shared factors contributing to EUGR incidence for weight, length, and head circumference. The significant factors for EUGR incidence for weight and length included whether the infant was small for gestational age, whether oxygen was administered at 36 weeks PMA, age in days at which breast-feeding was initiated, and age in days when the infant regained birthweight.
Conclusions:
The growth retardation of preterm LBW infants in the neonatal intensive care unit continues to pose challenges. Relevant factors other than gestational age include intrauterine growth restriction, severe chronic lung disease, and poor nutrition.
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