Postnatal growth failure of very low-birth-weight infants in Southwest Iran: A descriptive analytical study

Area of Science:

• Neonatal care
• Pediatric growth and development
• Public health

Background:

• Preterm infants, especially very-low-birth-weight (VLBW) neonates, face significant risks for impaired growth and neurodevelopment.
• Early postnatal weeks are critical for VLBW infant development.
• Growth failure is defined as body weight below the 10th percentile for postmenstrual age, per the Vermont Oxford Network.

Purpose of the Study:

• To determine the incidence of postnatal growth failure in very-low-birth-weight (VLBW) infants in Southwest Iran.
• To identify factors contributing to growth failure in this vulnerable population.

Main Methods:

• A descriptive analytical study was conducted on 353 VLBW infants admitted to Imam Khomeini Hospital's NICU in Ahvaz, Iran (September 2019 - August 2020).
• Growth failure was assessed at discharge using the Fenton growth chart, defining it as weight below the 10th percentile (≤-1.28 Z-score).
• Intrauterine growth retardation (IUGR) rates were analyzed by sex and gestational age.

Main Results:

• Intrauterine growth retardation (IUGR) was observed in 29% of female and 10.6% of male infants born at 32 and 31 weeks gestational age or higher, respectively.
• Postnatal growth failure at discharge was prevalent, affecting nearly all VLBW girls born at less than 32 weeks gestation and nearly all VLBW boys born at less than 33-34 weeks gestation.

Conclusions:

• The rate of postnatal growth retardation among VLBW infants in the studied NICU significantly exceeded that reported in other centers.
• Factors such as overcrowding, short hospital stays, low nurse-to-patient ratios, and inadequate nurse training were identified as potential contributors to poor postnatal growth.