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Postnatal Growth at 64 Weeks Postmenstrual Age in Preterm Infants Delivered at ≤ 34 Weeks' Gestation: A Single Center
Apoorva Kutar1, Padmasani Venkat Ramanan2, Kandathil Eapen Elizabeth3
1Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
Insights
More than half of preterm infants born at 34 weeks gestational age experienced slow postnatal growth. Exclusive breastfeeding for 6 months protected against abnormal weight gain in these vulnerable neonates.
Area of Science:
- Neonatalogy
- Pediatric Growth and Development
- Public Health Nutrition
Background:
- Preterm neonates born at or before 34 weeks gestational age are at increased risk for suboptimal postnatal growth.
- Understanding growth trajectories is crucial for early intervention and improved long-term outcomes in this population.
Purpose of the Study:
- To evaluate the postnatal growth patterns of preterm neonates at 64 weeks postmenstrual age (PMA).
- To identify factors influencing growth, including feeding practices, in infants born prematurely.
Main Methods:
- A cross-sectional study involving anthropometric measurements of 156 preterm neonates (≤ 34 weeks gestational age) at 64 (± 2) weeks PMA.
- Growth rate was categorized based on changes in z-scores for weight-for-age, length-for-age, and head circumference-for-age from birth to 64 weeks PMA.
- Statistical analysis identified risk factors associated with slow or rapid growth, including duration of exclusive breastfeeding (EBF).
Main Results:
- Over half of the infants exhibited slow weight gain (60.8%), length gain (55.7%), and head circumference gain (66.5%).
- Early complementary feeding was associated with an increased risk of slow weight gain.
- A longer duration of exclusive breastfeeding (EBF) was protective against both slow and rapid weight gain.
- Lower gestational age at birth, birth weight for gestation, and re-hospitalization were also key factors influencing growth.
Conclusions:
- Preterm infants born at ≤ 34 weeks gestational age frequently experience delayed postnatal growth in weight, length, and head circumference.
- Exclusive breastfeeding until 6 months corrected age demonstrates a protective effect against abnormal weight gain trajectories in preterm infants.
Objective:
To study the postnatal growth at 64 weeks postmenstrual age (PMA) in preterm neonates born at ≤ 34 weeks gestational age.
Methods:
A cross-sectional study was conducted between August, 2019 and November, 2021, wherein, we took anthropometric measurements of neonates (delivered at ≤ 34 weeks' gestation) at 64 (± 2) weeks PMA. The rapidity of postnatal growth was categorized according to change in the z-score of anthropometric measures, viz, weight-for-age, length-for-age and head circumference-for-age, between birth and 64 weeks PMA. For each of the growth parameters, growth rate was categorized according to the change in z-score (z-score at 64 weeks PMA minus z-score at birth) as slow (< -0.67), acceptable (-0.67 to < 0.67), and rapid (≥ 0.67).
Results:
Out of the 156 preterm neonates evaluated, weight gain was slow, acceptable and rapid in 95 (60.8%), 45 (28.9%), and 16 (10.3%), respectively. Length gain was slow, acceptable, and rapid in 87 (55.7%), 49 (31.4%), and 20 (12.9%) infants, respectively. Head circumference gain was slow, acceptable and rapid in 103 (66.5%), 42 (26.5%), and 11 (7.0%) infants, respectively. The risk [aOR (95% CI)] for slow weight gain increased with early initiation of complementary feeding [8.0 (3.5, 18.0)] and decreased with a longer duration of EBF [0.4 (0.2, 0.6), P < 0.001]. The risk for rapid weight gain also decreased with the longer duration of EBF [0.27 (0.1, 0.5), P < 0.001]. Gestational age < 32 weeks ,weight for gestation at birth, and re-hospitalization following discharge were the other key factors influencing the growth rate.
Conclusion:
Among babies born preterm (≤ 34 weeks), more than half had slow gain in weight, length and head circumference. EBF till 6 months corrected age was protective against slow and rapid weight gain.
