Growth and Body Composition at Discharge in Full-Term Neonates With Congenital Anomalies

To evaluate growth and body composition at NICU discharge in term-born neonates with structural congenital anomalies and identify predictors of body fat percentage.

This prospective observational study included 61 term neonates (≥ 37 weeks' gestation) with cardiac or non-cardiac congenital anomalies requiring surgery. Anthropometric measures at birth and discharge and body composition at discharge were measured.

Mean z-scores declined significantly between birth and discharge for weight (-0.38 to -1.53), length (-0.02 to -0.64), and head circumference (-0.04 to -0.79) (all p < 0.001). Infants with congenital heart disease demonstrated a more pronounced weight z-score decline. At discharge, mean body fat was 9% (SD 4.9), with no significant differences between cardiac and non-cardiac anomalies or sexes. Fat-free mass was relatively preserved (91%, 910 g/kg). Multivariate analysis identified time of full enteral feeds (p = 0.02) and maternal ethnicity (p = 0.03) as independent predictors of body fat.

Term neonates with congenital anomalies experience significant postnatal growth restriction and reduced fat mass by NICU discharge. Maternal ethnicity and time to full enteral feeds independently influence body fat percentage. These findings support the need for individualised nutrition and routine body composition monitoring to optimise outcomes in this high-risk group.