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Risk factors and outcomes for failure to thrive in low birth weight preterm infants
K J Kelleher1, P H Casey, R H Bradley
1Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock 72202.
Insights
Failure to thrive (FTT) affects nearly 20% of low birth weight (LBW) infants, leading to poorer cognitive and growth outcomes. Environmental and biological factors contribute to FTT development in these vulnerable infants.
Area of Science:
- Pediatrics
- Neonatology
- Developmental Biology
Background:
- Low birth weight (LBW) infants are at increased risk for growth deficiency.
- Failure to thrive (FTT) is a common clinical concern in pediatric care for growth-deficient infants.
Purpose of the Study:
- To investigate the epidemiology, clinical characteristics, and outcomes of LBW infants experiencing FTT.
- To identify factors associated with FTT in LBW infants.
Main Methods:
- A 3-year prospective cohort study involving 914 LBW infants across eight US university hospitals.
- Matched case-control analysis of outcomes was performed.
Main Results:
- Nearly 20% (19.7%) of LBW infants developed FTT by 30 months, with new cases peaking at 8 months corrected age.
- Infants with FTT exhibited lower developmental indices, less stimulating home environments, and poorer cognitive (IQ) and growth outcomes at 36 months.
- Most FTT cases (over 80%) lacked chronic medical conditions, highlighting biological and environmental influences.
Conclusions:
- FTT is a prevalent condition requiring attention in the follow-up care of LBW infants.
- LBW infants meeting FTT criteria show significantly worse cognitive and growth trajectories.
- Environmental and biological factors, beyond chronic medical issues, play a crucial role in FTT development among LBW infants.
Objective:
To determine the epidemiology, clinical characteristics, and outcomes for low birth weight (LBW) infants with growth deficiency, or failure to thrive (FTT, the term commonly used by pediatric providers to describe growth deficiency or faltering in early childhood).
Design:
Three-year prospective cohort study with matched case-control study of outcomes.
Setting:
Eight large university hospital sites throughout the United States.
Sample:
914 LBW infants inborn at the sites and meeting study criteria.
Results:
FTT was a common condition in this cohort, with 180 (19.7%) of 914 LBW infants meeting case criteria by 30 months. New cases of FTT peaked at 8 months gestation-corrected age. In addition to expected differences in growth between infants with and without FTT, infants with FTT had lower developmental indices and less stimulating home environments. At 36 months, FTT infants had lower IQ scores and were much smaller than infants without FTT.
Conclusions:
Growth deficiency, or FTT, is a common clinical condition for those involved in the follow-up care of LBW infants. Worse cognitive and growth outcomes were observed for those meeting the restrictive case criteria employed in this study. More than 80% of the cases in this LBW cohort did not involve any chronic medical disorders, but several biological and environmental differences were found between those who developed FTT and those who did not.