Rate of weight gain in very-low birth weight Puerto Rican neonates
Maribel Campos1, Lourdes García, Inés E García
1University of Puerto Rico School of Medicine, Department of Pediatrics, Neonatology Section. mcampos@rcm.upr.edu
Insights
Small for gestational age (SGA) neonates show different early weight gain patterns compared to appropriate for gestational age (AGA) infants. These growth disparities persist even after accounting for other health factors.
Area of Science:
- Neonatalogy
- Pediatric Growth and Development
- Perinatal Medicine
Background:
- Small for gestational age (SGA) neonates are at increased risk for growth delay.
- Early postnatal growth patterns are critical for long-term health outcomes in neonates.
Purpose of the Study:
- To investigate and compare early weight gain patterns between SGA and appropriate for gestational age (AGA) neonates.
- To determine if observed differences in weight gain persist after adjusting for confounding variables.
Main Methods:
- A matched cohort study included 216 neonates (SGA vs. AGA) born between 1999-2003.
- Weight gain rate calculated as grams/kilogram/day from birth to discharge.
- Two sample T-test and simple regression analysis used to compare growth rates and assess the impact of morbidities.
Main Results:
- The mean weight gain rate was significantly higher in SGA neonates (14.9 g/kg/d) compared to AGA neonates (11.9 g/kg/d) (P < 0.001).
- Low APGAR score and being SGA were significant predictors of weight gain rate in regression analysis.
- Observed growth disparities were not explained by differences in the incidence of morbidities.
Conclusions:
- Neonatal growth patterns differ based on birth weight adequacy (SGA vs. AGA).
- The study highlights distinct early growth trajectories for SGA neonates, independent of common morbidities.
Background:
Small for gestational age neonates have a higher risk of growth delay. The purpose of the study is to determine if there are differences in their early weight gain patterns that persist after adjusting for confounding variables.
Methods:
Two-hundred sixteen neonates born between 1999 and 2003 were included. The group for analysis was derived by matching all the SGA infants with AGA infants by sex, year of birth, and birth weight. The period of observation was from birth to date of discharge. Weight gain rate was defined as grams gained per kilogram of birth weight per day. Two sample T-test was used to determine the difference in growth rate between the groups. Simple regression was used to establish the effect of morbidities on weight gain rate.
Results:
The total mean birth weight was 1105 g (+/- 223 g), the mean gestational age was 30 weeks (+/- 2.7 weeks), and the mean weight gain rate was 13.4 g/kg/d (+/- 6.8 g/kg/d). The mean weight gain rate for the adequate for gestational age group was lower (11.9 g/kg/d +/- 7.6g versus 14.9 g/kg/d +/- 5.5 g) (P < 0.001). When all variables were analyzed using the lineal regression model, only having a low APGAR score (P = 0.02) and being small for gestational age (P = 0.0004) were significant.
Conclusions:
We conclude that the growth patterns of very low birth weight neonates are different based on the adequacy of their birth weight, and that the disparity in growth rate is not explained by the differences in the incidence of morbidities that affect growth.
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