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Postnatal growth in infants born before 30 weeks' gestation
Insights
Premature infants experience initial weight loss after birth, with more immature infants losing more weight. Despite later catch-up growth, their weight often remains below intrauterine growth curves.
Area of Science:
- Neonatalogy
- Pediatric Nutrition
- Growth and Development
Background:
- Premature infants born between 23 to 29 weeks' gestation require specialized nutritional support.
- Parenteral nutrition is often used to establish feeding before milk intake begins in these vulnerable infants.
Purpose of the Study:
- To determine the postnatal weight patterns of very premature infants up to 14 weeks after birth.
- To compare weight loss, regain time, and growth rates in relation to gestational age and birth weight status.
Main Methods:
- Retrospective analysis of 184 singleton survivors born between 23 to 29 weeks' gestation.
- Monitoring of postnatal weight, nutritional intake (parenteral and milk feeding), and growth parameters up to 14 weeks.
- Comparison of infants based on gestational age subgroups and small for gestational age (SGA) status.
Main Results:
- A mean postnatal weight loss of 14% of birth weight occurred around 6 days of age.
- More immature infants exhibited greater weight loss and longer recovery times, despite higher initial fluid intake.
- Postnatal weight gain exceeded intrauterine growth rates from the fourth week onwards for all gestational subgroups.
- Despite catch-up growth, mean body weight remained below the 10th percentile of the intrauterine growth curve.
- Infants small for gestational age showed higher early growth rates but remained significantly lighter at 2 years.
Conclusions:
- Very premature infants undergo significant initial postnatal weight loss, with recovery taking longer in more immature infants.
- While postnatal growth rates can surpass intrauterine rates, initial weight loss impacts long-term weight trajectory.
- Infants small for gestational age demonstrate catch-up growth but maintain lower body weight at 2 years, highlighting the need for continued monitoring.
Abstract:
The postnatal weight pattern up to 14 weeks after birth was determined in 184 singleton survivors born at 23 to 29 weeks' gestation in whom routine parenteral nutrition was used before milk feeding was established. A mean postnatal weight loss of 14% of birth weight occurred at a mean of 6 days. The more immature infants had significantly higher postnatal weight loss and longer time to regain birth weight despite a higher volume intake in the first week. From the fourth postnatal week all gestational subgroups had a mean weight gain at above intrauterine growth rate. As a result of the initial period of weight loss, however, the mean body weight remained below the 10th percentile of the intrauterine growth curve. The early growth rate in infants small for gestational age was higher than those who were appropriate weight for gestation, although the mean body weight of the former group remained significantly lower at 2 years.