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Risk Factors for Postnatal Growth Faltering and Undernutrition at Discharge in Very Preterm Infants: A Retrospective
Isadora Beghetti1,2, Dalila Magno1, Ettore Benvenuti1
1Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy.
Nutrients
|January 28, 2026
Summary
Nearly half of very preterm infants experience growth issues before hospital discharge. Identifying risk factors like bronchopulmonary dysplasia and birth growth restriction is key for targeted infant nutrition.
Area of Science:
- Neonatalogy
- Pediatric Nutrition
- Growth Monitoring
Background:
- Postnatal growth failure (GF) and undernutrition (UN) in very preterm infants are significant concerns.
- Lack of standardized definitions complicates clinical management.
- This study applies European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) criteria for GF and UN.
Purpose of the Study:
- To identify risk factors for growth faltering (GF) and undernutrition (UN) at hospital discharge in very preterm infants.
- To apply standardized ESPGHAN criteria for defining GF and UN.
- To understand distinct clinical trajectories of growth impairment.
Main Methods:
- Retrospective observational study of 416 preterm infants (gestational age < 32 weeks and/or birth weight < 1500 g).
- Growth monitored using Intergrowth 21st standards.
- GF defined as ≥ 1 SD weight-for-age z-score decline; UN as z-score < -2 at discharge.
- Logistic regression used to identify independent predictors.
Main Results:
- Prevalence of GF was 45.3% and UN was 33.1% at discharge.
- Bronchopulmonary dysplasia and maximal postnatal weight loss were key risk factors for GF.
- Female sex and human milk feeding were associated with lower GF risk.
- Maternal hypertension, extremely low birth weight, and GF predicted UN in infants with adequate birth weight.
Conclusions:
- Almost half of very preterm infants exhibit significant growth impairment before discharge.
- Assessing both GF dynamics and UN endpoints reveals distinct patient trajectories.
- Standardized ESPGHAN criteria aid in identifying high-risk infants for targeted nutritional support.
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