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Relationship between Early Antibiotic Exposure and Short-Term Growth Velocity in Premature Neonates
Brittany M Reid1, Ruth Eisenberg2, Katie Forman1
1Division of Neonatology, Department of Pediatrics, Children's Hospital at Montefiore, Bronx, New York.
Insights
Early antibiotic exposure in newborns did not impact growth velocity during hospitalization. This study found no significant difference in growth rates based on antibiotic duration in the first week of life.
Area of Science:
- Neonatal Medicine
- Pediatric Pharmacology
- Growth and Development
Background:
- Antibiotic use in neonates is common, but its effect on growth is not fully understood.
- Understanding the relationship between early antibiotic exposure and infant growth is crucial for optimizing neonatal care.
Purpose of the Study:
- To investigate the association between the duration of antibiotic administration in the first week of life and subsequent in-hospital growth velocity in preterm infants.
Main Methods:
- Retrospective study of infants born between 30 and 326/7 weeks' gestational age.
- Antibiotic duration categorized as no antibiotics, <5 days, or ≥5 days.
- Comparison of weight Z-score changes and growth velocity metrics between groups using analysis of variance.
Main Results:
- Infants receiving ≥5 days of antibiotics had lower gestational age and more comorbidities.
- No significant differences in growth velocity or weight Z-score changes were observed between antibiotic exposure groups.
- Higher admission and discharge weight Z-scores were noted in the ≥5 days antibiotic group, but this did not correlate with growth velocity.
Conclusions:
- Early antibiotic exposure in the first week of life was not associated with altered in-hospital growth velocity in preterm infants.
- Study limitations include retrospective design and lack of post-discharge follow-up data.
Objective:
To characterize the relationship between the duration of antibiotic administration during the first week of life and subsequent growth velocity during hospitalization.
Study Design:
This was a retrospective study comparing the inhospital growth of infants born between 30 and 326/7 weeks' gestational age (GA) admitted to the Montefiore Weiler and Wakefield neonatal intensive care units between January 2009 and December 2015. Antibiotic duration during the first week of life was classified as no antibiotics, <5 days of antibiotics, or ≥5 days of antibiotics. Differences between discharge and birth weight Z-scores were compared between the three groups using analysis of variance.
Results:
Of the infants, 87% received antibiotics during the first week of life, with 16% of infants completing ≥5 days. Compared with infants receiving ≤5 days of antibiotics, infants treated with ≥5 days had a lower GA, lower Apgar scores, more invasive respiratory support, longer duration of total parenteral nutrition, delayed initiation of enteral feeding, and a higher weight Z-score on admission and discharge (p < 0.05). However, there was no distinction in growth between the three groups assessed by the difference between admission and discharge weight Z-scores (p = 0.64), growth velocity (gram/kilogram/day) (p = 0.104), or an exponential growth velocity outcome (p = 0.423).
Conclusion:
Early antibiotic exposure was not associated with increased growth velocity between birth and discharge. Our study was limited by its retrospective nature and lack of follow-up data postdischarge.
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