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Updated: Jun 6, 2026
Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Which is the ideal target for preterm growth?
1Pediatric Section, University of Ferrara, Italy.
Insights
Postnatal growth failure is common in very low birth weight (VLBW) infants despite improved survival. Early nutritional management is crucial to prevent long-term health and neurodevelopmental issues.
Area of Science:
- Neonatology
- Pediatric Growth and Development
- Nutritional Science
Background:
- Improved survival rates for very low birth weight (VLBW) and extremely low birth weight (ELBW) infants highlight the challenge of postnatal growth failure.
- Despite advancements in neonatal care, most VLBW/ELBW infants experience significant extrauterine growth restriction (EUGR).
Purpose of the Study:
- To review the causes and consequences of postnatal growth failure in VLBW/ELBW infants.
- To emphasize the importance of early nutritional management in optimizing growth and long-term outcomes.
Main Methods:
- Literature review of factors contributing to EUGR in VLBW/ELBW infants.
- Analysis of the impact of growth impairment on neurodevelopment and long-term health.
- Discussion of current strategies and future directions in neonatal nutrition.
Main Results:
- Frequent illnesses, medical interventions, feeding intolerance, and inadequate nutrient delivery are primary causes of EUGR.
- Growth impairment, particularly affecting head circumference, negatively impacts neurodevelopmental outcomes.
- While catch-up growth occurs, VLBW infants often remain smaller than term peers.
Conclusions:
- Optimizing early nutrient delivery is essential for VLBW/ELBW infants to achieve adequate growth rates (18-20 g/kg/d).
- Preventing EUGR through appropriate neonatal nutrition can mitigate long-term health risks and improve neurodevelopmental trajectories.
- Further research is needed to fully understand the endocrine, metabolic, and cardiovascular consequences of neonatal nutrition.
Abstract:
In the last two decades the improved survival of very low birth weight (VLBW) and extremely low birth weight (ELBW) infants has underscored the problem of postnatal growth failure of these subjects. Notwithstanding the evident improvements in the general management of these infants during the hospital stay, most of them acquire a significant extrauterine growth restriction (EUGR). Frequent illnesses, medical and surgical therapies, feeding intolerance and, most of all, inadequacy of nutrient deliveries are responsible for the great part of this growth failure. However other factors, such as genetics, prenatal environment, hormones and metabolic pathways may contribute to growth impairment, that my persist until adulthood. Most of VLBW infants exhibit some catch-up growth, especially in late childhood and adolescence, but they generally remain smaller than their term peers. However, the most worrying aspect is related to the detrimental effect of growth impairment, especially if involving head circumference, on neurodevelopment outcomes of these infants. The endocrine, metabolic and cardiovascular long term consequences of under- and/or hypernutrition of VLBW infants are still to be elucidated. In the meantime, the efforts of the neonatotolgists should be focused on improving, how much as possible, the early nutrient management of these infants, allowing them to reach an adequate growth rate (at least 18-20 g/kg/d), then avoiding the need of a late unphysiological catch-up growth.
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