Changes in nutritional management and outcome of very-low-birth-weight infants

Area of Science:

• Neonatology
• Pediatric Growth and Development
• Nutritional Support

Background:

• Growth faltering is a significant concern in preterm very-low-birth-weight infants.
• Early postnatal nutrition and medical management impact long-term outcomes.
• Changes in medical practices may influence infant growth trajectories.

Purpose of the Study:

• To compare the in-hospital and postdischarge growth of very-low-birth-weight infants born in 1982 versus 1986.
• To identify factors contributing to differences in growth and neurodevelopmental outcomes.

Main Methods:

• Retrospective comparison of two cohorts of preterm very-low-birth-weight infants (1982 vs. 1986).
• Analysis of nutritional intake, medical interventions (e.g., patent ductus arteriosus treatment), and complications.
• Assessment of growth percentiles and neurodevelopmental status at hospital discharge and at 4 and 12 months corrected age.

Main Results:

• Infants born in 1986 received earlier nutritional support and earlier treatment for patent ductus arteriosus.
• The 1986 cohort exhibited significantly higher growth percentiles by discharge and fewer infants below the fifth percentile for weight and occipitofrontal circumference.
• Improved growth persisted at 4 and 12 months corrected age, with fewer major neurologic abnormalities in the 1986 group.

Conclusions:

• Earlier and more aggressive nutritional management, improved cardiopulmonary care, and reduced complications in 1986 promoted better postnatal growth.
• Enhanced early growth in very-low-birth-weight infants is associated with improved neurodevelopmental outcomes at 12 months corrected age.
• These findings highlight the critical role of optimized neonatal care in long-term infant development.