Risk Factors Associated with Extrauterine Growth Restriction (EUGR) Among Hospitalised Preterm Neonates <34 Weeks of...

To estimate the incidence of extrauterine growth restriction (EUGR) in neonates born before 34 wk of gestation and identify associated risk factors.

A prospective cohort study was conducted in a Level III neonatal intensive care unit (NICU) from December 2019 to October 2021, including preterm neonates (<34 wk gestation) admitted and survived at least three weeks and crossed birth weight. Neonates with congenital malformations or those transferred before three weeks were excluded. Anthropometric measurements were taken at birth and discharge, and clinical, nutritional, and comorbidity data were analysed. Univariate and multivariate logistic regression identified risk factors for EUGR.

Among 152 eligible preterm neonates, the incidence of EUGR was 54.6% (n = 83), with higher rates in extreme preterm (68.9%; n = 20) and very low birth weight (VLBW) infants (75%; n = 63). Lower gestational age, lower birth weight, prolonged total parenteral nutrition (TPN) use, delayed full feeds, and later Kangaroo mother care (KMC) initiation were significantly associated with EUGR. Multivariate analysis identified gestational age {(aOR-14.5  (4.7-45)} and delayed KMC initiation {(aOR-1.3  (1.1-1.5)} as independent predictors of EUGR.

EUGR remains a major concern in preterm neonates, particularly in extremely low birth weight infants. Delayed initiation of KMC was identified as a modifiable risk factor. Early initiation of KMC in NICU settings could be prioritized to reduce EUGR incidence.