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Postnatal growth of small for gestational age late preterm infants: determinants of catch-up growth
Giulia Vizzari1, Daniela Morniroli2,3, Valentina Tiraferri4
1Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy.
Insights
Late preterm infants who are small for gestational age often fail to recover growth. Breastfeeding protects against this failure to thrive, underscoring the importance of promoting human milk for these vulnerable infants.
Area of Science:
- Neonatalogy
- Pediatric Growth and Development
- Human Lactation
Background:
- Late preterm infants (born between 34-36 weeks gestation) with birth weights at or below the 10th percentile are at risk for growth failure.
- Failure to achieve adequate weight and stature recovery within the first 36 months of life is a significant concern in this population.
Purpose of the Study:
- To evaluate the auxological (growth) outcomes of late preterm infants.
- To identify factors associated with the failure to recover growth in this cohort.
Main Methods:
- A cohort of 175 late preterm infants with birth weight ≤10th percentile was followed.
- Data collected at birth and follow-up visits included auxological measurements.
- Logistic regression analysis identified variables associated with growth failure.
Main Results:
- 34% of infants showed no weight recovery by 36 months.
- Failure to regain weight by 12 months predicted continued growth failure at 36 months for both weight and length.
- Infants receiving any human milk at discharge demonstrated protection against failure to achieve catch-up growth.
Conclusions:
- Late preterm infants who are small for gestational age are at high risk for impaired weight and stature recovery up to 36 months.
- The protective effect of human milk highlights the critical role of breastfeeding in preventing failure to thrive in this vulnerable population.
Background:
Failure to recover growth is a risk reported in late preterm population. This study aimed to evaluate the auxological outcome of late preterm infants and identify factors associated with failure to recover growth.
Methods:
We enrolled late preterm infants with birth weight ≤10th percentile, followed up at High-Risk Infant Follow-up Service. We collected data at birth and at follow-up visits. A logistic regression analysis was performed to assess variables independently associated with growth failure.
Results:
The population consisted of 175 preterms. The percentage of children showing no weight recovery was 34% at 36 months. At logistic regression analysis, infants who had not regained weight at 12 months had a higher risk of not regaining weight even at 36 months. The same risk factor was highlighted for length catch-up growth. Moreover, infants fed any human milk at discharge were protected from not achieving both weight and length catch-up growth at 36 months.
Conclusion:
These results indicate that children born late preterm and small for gestational age could fail to recover weight and stature growth in the first 36 months. The protective effect of human milk on failure to thrive highlights the importance of promoting breastfeeding in this population.
Impact:
A significant number of SGA late preterms show a failure to recover weight and statural growth. Having experienced intrauterine growth restriction is associated with a greater chance of achieving statural catch-up growth. Being born singleton represents a risk factor for slower weight and height growth velocity. Breastmilk has a protective effect on failure to recover adequate weight and length in preterm SGA infants. This finding highlights the importance of promoting breastfeeding in this population.
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