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Catch-down growth in infants born large for gestational age

Rachel K Dunn1, Michael Uhing2, Praveen S Goday3

  • 1Division of Pediatric Gastroenterology, Peyton Manning Children's Hospital, Indianapolis, Indiana, USA.

Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
|July 10, 2021
PubMed

Insights

Infants born large for gestational age (LGA) without catch-down growth face higher obesity risks. Neonatal nutrition interventions are common in the NICU for these infants, but further research is needed to optimize care.

Area of Science:

  • Neonatology
  • Pediatric Nutrition
  • Growth Monitoring

Background:

  • Infants born large for gestational age (LGA) lacking catch-down growth are at increased risk for future obesity.
  • Identifying LGA infants in the neonatal intensive care unit (NICU) and understanding growth patterns are crucial for early intervention.

Purpose of the Study:

  • To identify term LGA infants admitted to the NICU.
  • To document nutrition interventions provided to LGA infants.
  • To analyze the relationship between interventions, growth patterns, and length of stay (LOS).

Main Methods:

  • Retrospective review of 47 term LGA infants with NICU LOS ≥7 days over 10 years.
  • Collection of demographic data, NICU nutrition interventions, and growth pattern data.
  • Analysis of catch-down growth, defined as a weight z-score decline of 1.

Main Results:

  • 66% of term LGA infants demonstrated catch-down growth at discharge (≥7 days).
  • 83% received NICU nutrition interventions, including nasogastric tubes (69%) and formula fortification (51%).
  • Infants without catch-down growth and longer LOS (≥14 days) were more likely to receive interventions.

Conclusions:

  • Nutrition interventions are frequently administered to LGA infants in the NICU.
  • The study underscores the need for further clinical research to guide optimal care strategies for this high-risk population.
  • Understanding growth trajectories in LGA infants is essential for predicting and potentially mitigating long-term health risks like obesity.

Keywords:
critical illnessgrowthinfantneonatal intensive care unitpediatrics

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