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Neonatal morbidities and postnatal growth failure in very low birth weight, very preterm infants

Noa Ofek Shlomai1, Brian Reichman2,3, Inna Zaslavsky-Paltiel2

  • 1Department of Neonatology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Acta Paediatrica (Oslo, Norway : 1992)
|May 1, 2022
PubMed

Insights

Infants born with very low birth weight (VLBW) face challenges in postnatal growth, especially those with major neonatal morbidities. These infants show significantly higher rates of growth failure, necessitating personalized care plans.

Area of Science:

  • Neonatalogy
  • Pediatric Growth and Development
  • Perinatal Medicine

Background:

  • Postnatal growth failure (PNGF) is a significant concern in very low birth weight (VLBW) infants.
  • Major neonatal morbidities can complicate growth trajectories in VLBW populations.
  • Understanding the impact of specific morbidities on PNGF is crucial for targeted interventions.

Purpose of the Study:

  • To assess and compare postnatal growth outcomes in VLBW infants with and without major neonatal morbidities.
  • To quantify the incidence of severe, mild, and no postnatal growth failure (PNGF) based on the presence of morbidities.
  • To identify specific neonatal morbidities that most significantly impact PNGF in VLBW infants.

Main Methods:

  • Analysis of a large cohort of VLBW infants (≤1500 g) from the Israel Neonatal Network (2009-2018).
  • Categorization of infants into two epochs (2009-2013 and 2014-2018) to assess trends.
  • Utilized multinomial logistic regression with generalized estimating equations to analyze the association between morbidities and PNGF outcomes.

Main Results:

  • A total of 9141 VLBW infants were analyzed; 2089 had major morbidities, and 7052 had none.
  • Infants with major neonatal morbidities exhibited significantly higher rates of severe (13.6% vs. 2.1%) and mild (43.9% vs. 23.7%) PNGF compared to those without (p < 0.0001).
  • Conversely, infants without morbidities had a higher rate of no PNGF (74.2% vs. 42.5%).

Conclusions:

  • Despite advances in neonatal care, achieving optimal postnatal growth in VLBW infants, particularly those with major morbidities, remains a significant challenge.
  • Infants with major neonatal morbidities are at a substantially higher risk for diminished growth.
  • Personalized follow-up plans are essential for VLBW infants with major morbidities to mitigate growth deficits and potential adverse neurodevelopmental outcomes.
Abstract

Keywords:
neonatal morbiditiesnutritionpostnatal growth failurepretermvery low birth weight

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