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Nutritional status of light-for-date infants at birth and its influence on early postnatal growth
Insights
Light-for-date (LFD) infants often show signs of intrauterine undernutrition at birth. These infants experience rapid "catch-up" growth in the first three months post-birth.
Area of Science:
- Pediatrics
- Neonatology
- Human Growth and Development
Background:
- Light-for-date (LFD) infants are born with low birth weight relative to gestational age.
- Intrauterine undernutrition is a significant concern for LFD infants' long-term health.
- Assessing nutritional status at birth is crucial for understanding postnatal growth trajectories.
Purpose of the Study:
- To define the nutritional status of LFD infants at birth using the ponderal index (PI).
- To investigate the influence of intrauterine undernutrition on postnatal growth in LFD infants during the first six months of life.
Main Methods:
- Utilized the ponderal index (PI) to assess nutritional status at birth in 47 LFD term infants.
- Compared growth rates (weight, head circumference, length) between 'wasted' (PI < 3rd centile) and 'nonwasted' (PI > 10th centile) LFD infants.
- Analyzed growth data at four postnatal intervals: 0–4, 5–8, 9–12, and 13–26 weeks.
Main Results:
- A high prevalence of low ponderal index (PI) was observed, indicating underweight for length in most LFD infants, suggesting intrauterine undernutrition.
- In the first month, 'wasted' LFD infants exhibited faster weight gain and greater increases in head circumference and length compared to 'nonwasted' infants.
- Postnatal growth rates for weight, length, and head circumference in both LFD groups exceeded those of normal infants during the first three months.
Conclusions:
- The ponderal index (PI) effectively identifies LFD infants likely affected by intrauterine undernutrition.
- The first three months post-birth represent a critical 'catch-up' growth period for LFD infants.
- LFD infants demonstrate accelerated postnatal growth, particularly in the initial postnatal period, to compensate for intrauterine growth restriction.
Abstract:
The ponderal index (PI) (g/cm3 X 100) was used to define the state of nutrition at birth of 47 light-for-date (LFD) term infants and to determine how intrauterine undernutrition influences growth during the first 6 months of postnatal life, at four age intervals: birth--4, 5--8, 9--12, 13--26 weeks. With the exception of one baby, each PI was less than 50th centile on the Miller and Hassanein standards: in 24 (51%) babies the PI was less than 3rd centile. This suggests that, generally, LFD infants are underweight for length, and by inference, are likely to have experienced intrauterine undernutrition. In the first month the 24 'wasted' infants (PI less than 3rd centile) gained more rapidly in weight, and grew more quickly in head circumference and length than the 16 'nonwasted' infants (PI greater than 10th centile). Thereafter growth rates were similar. With the exception of weight in the 'nonwasted' infants during the first month, rates of growth (weight, length, and head circumference) in both groups of babies in each of the 3 months after birth were greater than in normal infants. The first 3 months after birth can therefore be defined as the period of 'catch-up' growth in LFD term infants.