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Applying Methods for Postnatal Growth Assessment in the Clinical Setting: Evaluation in a Longitudinal Cohort of Very

Montserrat Izquierdo Renau1, Victoria Aldecoa-Bilbao2, Carla Balcells Esponera1

  • 1Neonatology Department, Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Universidad de Barcelona, BCNatal, Esplugues de Llobregat, 08950 Barcelona, Spain.

Nutrients
|November 20, 2019
PubMed

Insights

Assessing postnatal growth in very premature infants (VPI) using z-scores is effective for identifying growth faltering. Minimizing initial weight loss and ensuring adequate nutrition can reduce postnatal growth failure in at-risk VPI.

Area of Science:

  • Neonatalogy
  • Pediatric Growth and Development
  • Clinical Nutrition

Background:

  • Very premature infants (VPI) face significant challenges in achieving optimal postnatal growth.
  • Extrauterine growth restriction (EUGR) and postnatal growth failure (PGF) are common complications in VPI.
  • Early identification of growth faltering is crucial for timely intervention.

Purpose of the Study:

  • To evaluate different methods for assessing postnatal growth in VPI.
  • To identify early indicators of growth failure in a clinical setting.
  • To explore associations between clinical/nutritional factors and growth outcomes in VPI.

Main Methods:

  • A cohort of 197 VPI (≤32 weeks gestation) was studied during their hospital stay.
  • Growth velocity (GV), EUGR, and PGF were calculated at 36 weeks postmenstrual age (PMA).
  • Linear and logistic regression analyses explored relationships between growth and clinical/nutritional variables.

Main Results:

  • At 36 weeks PMA, 66.0% of VPI experienced EUGR, and 67.4% had PGF.
  • PGF prevalence was higher in non-IUGR VPI (70.5%) compared to IUGR VPI (48.1%).
  • Initial weight loss, oxygen requirement, and reduced early parenteral lipid intake were associated with PGF.

Conclusions:

  • Z-score analysis is a superior method for detecting postnatal growth faltering in VPI.
  • Minimizing initial weight loss and optimizing nutrition can mitigate PGF in at-risk infants.
Abstract

Keywords:
extrauterine growth restrictionfall in z-scoreintrauterine growth restrictionpostnatal growth failure

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