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Weight gain speed and z-score behavior in large prematures for gestational age
Betânia Boeira Scheer1, Andriele Madruga Peres2, Eduarda de Souza Silva1
1Programa de Pós-Graduação em Nutrição e Alimentos. Faculdade de Nutrição. Universidade Federal de Pelotas.
Insights
Premature infants large for gestational age (LGA) experienced slower weight gain compared to appropriate for gestational age (AGA) neonates. Growth factors significantly influenced weight z-scores in these premature infants during hospitalization.
Area of Science:
- Neonatalogy
- Pediatric Nutrition
- Growth Monitoring
Background:
- Premature infants require careful monitoring of growth and weight gain.
- Large for gestational age (LGA) premature neonates may face unique nutritional challenges.
- Understanding weight gain patterns is crucial for optimizing neonatal intensive care unit (NICU) outcomes.
Purpose of the Study:
- To investigate the rate of weight gain (WG) and weight z-score (E-z) in premature neonates classified as large for gestational age (LGA) versus appropriate for gestational age (AGA).
- To analyze the factors influencing weight gain and weight z-score changes during the first four weeks of hospitalization in premature infants.
Main Methods:
- Retrospective longitudinal study of 115 premature neonates (gestational age 27-37 weeks) admitted to a university hospital NICU.
- Weight gain (g/kg/day) calculated from nadir weight; weight z-score (E-z) computed using Intergrowth-21st curves.
- Repeated-measures ANOVA and multiple linear regression used to assess associations between weight gain, E-z, and explanatory variables.
Main Results:
- Premature LGA neonates exhibited significantly lower weight gain (9.2 ± 5.6 g/kg/day) compared to AGA neonates (13.9 ± 6.0 g/kg/day).
- Protein supply influenced WG in AGA infants, while gestational age impacted WG in LGA infants.
- Weight z-scores decreased similarly in both LGA and AGA groups by the fourth week, with growth explaining this variation.
Conclusions:
- Premature LGA neonates demonstrate reduced weight gain during the neonatal period compared to their AGA counterparts.
- Both linear and brain growth are key determinants of weight z-score variations in premature infants, irrespective of their LGA or AGA status.
Introduction:
Objective: to investigate the speed of weight gain (WG) and the z-score (E-z) of weight in premature neonates large for gestational age (LGA) during four weeks of hospitalization. Methods: a retrospective longitudinal study with premature neonates in a neonatal intensive care unit at a university hospital. Data were obtained from January 2017 to December 2018; 115 babies with gestational age (GA) ≥ 27 and < 37 weeks, non-twin, AGA or LGA were included. The WG (g/kg/day) was obtained from the nadir weight and the E-z was calculated online based on the Intergrowth-21st curves. Repeated-measures ANOVA and multiple linear regression were used to assess the association between WP and E-z and explanatory variables; p < 5 %. Results: mean GA was 32.5 weeks, birth weight was 1910 g and weight loss was 5 % at 7 days. WG was lower in LGA babies, with GI between 32 and 37 weeks (LGA, 9.2 ± 5.6 g/kg/day vs AGA, 13.9 ± 6.0 g/kg/day). The change in WG was explained by protein supply in AGA (B = 2.5 g/kg/day; 95 % CI, 0.7 to 4.3; and β = 0.543) and by GA in LGA (B = -0.05 g/kg/day; 95 % CI, -0.09 to -0.02; and β = -0.574). In the 4th week of hospitalization, weight E-z decreased similarly for LGAs and AGAs, and this variation was explained by growth. Conclusions: premature LGAs had lower WG compared to AGAs during the neonatal period. The linear and brain growth explained the variation in weight E-z among these preterms.
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