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Growth in high risk infants <1500 g birthweight during the first 5 weeks

A Loui1, E Tsalikaki, K Maier

  • 1Department of Neonatology, Charité Virchow-Hospital, Humboldt University, Berlin, Germany. andrea.loui@charite.de

Early Human Development
|June 10, 2008
PubMed

Insights

Disease severity and treatments like mechanical ventilation and dexamethasone significantly impair growth in very low birthweight (VLBW) infants. Current feeding practices are insufficient to achieve fetal growth rates in these vulnerable infants.

Area of Science:

  • Neonatal intensive care
  • Pediatric growth and development
  • Clinical nutrition

Background:

  • Growth monitoring in very low birthweight (VLBW) infants is crucial for assessing nutrition and aiming for intrauterine growth velocity.
  • Postnatal growth failure in VLBW infants is a significant concern, often attributed to nutritional deficits.

Purpose of the Study:

  • To investigate the hypothesis that disease severity, in addition to nutrition, contributes to growth failure in VLBW infants.
  • To identify specific factors related to critical illness and its management that impact infant growth.

Main Methods:

  • A prospective longitudinal study was conducted on 45 VLBW infants requiring intensive care.
  • Mechanical ventilation was utilized as a proxy for disease severity.
  • Nutritional intake, body weight, length, head circumference, and lower leg length (LLL) were systematically measured over the first 5 weeks of life.

Main Results:

  • Ventilated infants had lower birthweight and gestational age compared to unventilated infants.
  • Artificial ventilation and dexamethasone treatment were independent predictors of reduced weight gain.
  • Ventilated infants exhibited significantly lower median weight gain, head growth, and LLL growth compared to non-ventilated infants.
  • Dexamethasone treatment was associated with growth arrest, particularly affecting LLL gain.

Conclusions:

  • Current feeding practices are inadequate to support fetal growth rates in VLBW infants.
  • Postnatal growth failure in VLBW infants is multifactorial, influenced by both nutritional status and disease-related factors, including intensive care interventions.
  • Disease severity and treatments like mechanical ventilation and dexamethasone play a significant role in hindering growth in VLBW infants.
Abstract

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