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Published on: November 20, 2015
Early growth of preterm infants with prolonged hospitalisation
Xi-Fang Ru1, Qi Feng, Ying Wang
1Department of Paediatrics, Peking University First Hospital, Beijing, China.
Insights
Early growth restriction is common in preterm infants requiring prolonged hospitalization. Body weight Z-scores at 40 weeks corrected gestational age and 61 days corrected age can predict future weight gain.
Area of Science:
- Neonatology
- Pediatric Growth and Development
Background:
- Preterm infants often experience prolonged hospitalizations.
- Early growth patterns and influencing factors in this population require further investigation.
Purpose of the Study:
- To determine early growth patterns of preterm infants with prolonged hospital stays using body weight Z-scores.
- To identify factors and predictors influencing their growth trajectory.
Main Methods:
- Enrolled preterm infants with singleton pregnancies and prolonged hospital stays (≥28 days).
- Monitored body weight Z-scores and incidence of underweight infants periodically.
- Analyzed influencing factors and potential predictors of growth up to 91 days corrected age.
Main Results:
- Body weight Z-scores decreased across gestational age groups, reaching a minimum at 36 weeks corrected gestational age (CGA).
- By corrected full-term, Z-scores recovered to birth levels, exceeding those at 36 weeks CGA.
- Established predictive formulas for body weight Z-scores at 40 weeks CGA and identified cut-off values for predicting underweight risk at 183 days corrected age.
Conclusions:
- Early growth restriction is a significant clinical challenge for preterm infants with extended hospitalizations.
- Body weight Z-scores at 40 weeks CGA and 61 days corrected age serve as reliable predictors for body weight gain up to 183 days corrected age.
Introduction:
This study aimed to determine the early growth patterns of preterm infants who required prolonged hospitalisation in terms of body weight Z-score, and to explore the influencing factors and predictors of their growth.
Methods:
The criteria of enrolment included preterm birth, singleton pregnancy, hospitalisation within the first 24 hours of life, hospital stay ≥ 28 days and clinical follow-up beyond 91 days of corrected age. Body weight Z-scores and the incidence of underweight infants were reviewed periodically, and the influencing factors and possible predictors of growth analysed.
Results:
Body weight Z-scores of all infants of gestational age (GA) groups kept decreasing, with a trough seen at 36 weeks corrected gestational age (CGA). At corrected full-term, body weight Z-scores for all birth weight groups achieved birth level and were higher than that at 36 weeks CGA. Body weight Z-scores at 61 days corrected age was (-0.300 × GA [weeks] + 0.210 × birth weight [g] + 0.682 × body weight Z-score) at 40 weeks CGA. The cut-off values for body weight Z-score at birth (cut-off, -1.79; sensitivity, 100%; specificity, 91.3%) and 61 days corrected age (cut-off, -1.95; sensitivity, 100%; specificity, 97.1%) were selected to predict the risk of being underweight at 183 days corrected age.
Conclusion:
Early growth restriction is a practical problem in preterm infants with prolonged hospitalisation. Body weight Z-scores at 40 weeks CGA and 61 days corrected age can be used to predict body weight gain prior to 183 days corrected age in these infants.
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