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Predictors and Risk Scoring of Postnatal Growth Failure in Very-Low-Birth-Weight Infants.

Nutcha Singhasem1, Gunlawadee Maneenil1, Anucha Thatrimontrichai1

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Postnatal growth failure (PGF) affects many very-low-birth-weight (VLBW) infants. Key risk factors include low birth weight, multiple births, and pregnancy complications, aiding early identification and intervention.

Keywords:
extrauterine growth retardationpostnatal growth failurepredictionspreterm infantrisk factors

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Area of Science:

  • Neonatalogy
  • Pediatric Growth and Development
  • Perinatal Medicine

Background:

  • Postnatal growth failure (PGF) is a significant concern in very-low-birth-weight (VLBW) infants.
  • Early identification of neonates at risk for PGF is crucial for timely intervention.

Purpose of the Study:

  • To identify factors associated with PGF in VLBW infants.
  • To develop a predictive model for early risk stratification of neonates susceptible to PGF.

Main Methods:

  • Retrospective cohort study of VLBW infants (2014-2024).
  • PGF defined using the 2013 Fenton growth chart.
  • Multivariate logistic regression and receiver operating characteristic (ROC) curve analysis were employed.

Main Results:

  • Among 481 VLBW infants, 69.4% experienced PGF.
  • Significant predictors included birth weight < 750 g and 750-1000 g, multiple births, pregnancy-induced hypertension, oligohydramnios, lack of antenatal corticosteroids, and formula/mixed feeding.
  • The developed risk score demonstrated good predictive performance (AUC 0.736).

Conclusions:

  • Low birth weight (<1000 g), multiple births, pregnancy-induced hypertension, oligohydramnios, absence of antenatal corticosteroids, and specific feeding methods are key predictors of PGF.
  • The derived risk score can aid in early identification and targeted nutritional support for at-risk VLBW infants.