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Cumulative impact of multiple evidence based strategies on postnatal growth of extremely-low-birth-weight infants

Praveen Kumar1, Jeanne Perino2, Laura Bowers2

  • 1Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, IL, United States.

Clinical Nutrition (Edinburgh, Scotland)
|June 16, 2021
PubMed

Insights

Aggressive nutritional strategies did not prevent growth failure in extremely-low-birth-weight (ELBW) infants. Many ELBW survivors remained small for gestational age (SGA) at discharge, indicating persistent growth challenges.

Area of Science:

  • Neonatalogy
  • Pediatric Nutrition
  • Growth and Development

Background:

  • Postnatal growth failure is a significant concern in very preterm infants.
  • This growth failure is linked to poorer neurodevelopmental outcomes.

Purpose of the Study:

  • To assess the combined effect of multiple evidence-based strategies on the postnatal growth of extremely-low-birth-weight (ELBW) infants.
  • To evaluate the impact of optimized parenteral and enteral nutrition on ELBW infant growth.

Main Methods:

  • A prospective observational study was conducted.
  • Optimal parenteral and enteral nutrition strategies were implemented based on current literature.
  • Daily nutrient intakes (calories, protein, lipids, carbohydrates) were calculated.
  • Growth velocity (GV), length, and head circumference gains were measured.

Main Results:

  • The study included 38 ELBW survivors (mean gestational age 27.0 weeks).
  • Mean GV was 13.2 g/kg/day, with length and head circumference gains of 0.88 cm/week and 0.71 cm/week, respectively.
  • A high percentage of infants (76.3%) were small-for-gestational-age (SGA) at discharge, with 60.5% below the 3rd percentile for weight.

Conclusions:

  • Despite intensive nutritional support, all infants born SGA and most ELBW survivors born appropriate-for-gestational-age (AGA) were below the 10th percentile for weight, length, and head circumference at discharge.
  • Infants experiencing multiple morbidities or prolonged periods without enteral feeds exhibited lower growth velocity.
Abstract

Keywords:
Extremely-low-birth-weight (ELBW) infantGrowth velocityNutritionPostnatal growth failure

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