Primary follow-up care in a multidisciplinary setting enhances catch-up growth of very-low-birth-weight infants
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Multidisciplinary primary care with a registered dietitian significantly improved catch-up growth in length and head circumference for very-low-birth-weight infants by 12 months corrected age.
Area of Science:
- Pediatrics
- Neonatology
- Nutritional Science
Background:
- Very-low-birth-weight (VLBW) infants often experience growth faltering.
- Optimizing growth in VLBW infants is crucial for long-term health outcomes.
- Standard pediatric follow-up may not adequately address nutritional needs for catch-up growth.
Purpose of the Study:
- To evaluate the impact of multidisciplinary primary care follow-up, including registered dietitian services, on the growth outcomes of VLBW infants.
- To compare catch-up growth in VLBW infants receiving standard vs. comprehensive care.
Main Methods:
- Retrospective analysis of medical records comparing two groups of VLBW infants (< or = 1,500 g at birth).
- Group 1: As-needed follow-up in a general pediatric clinic (n=42).
- Group 2: Multidisciplinary follow-up with routine nutrition intervention in a comprehensive care clinic (n=33).
- Growth parameters (weight, length, head circumference), growth rates, and catch-up growth (>= 5th percentile by 12 months corrected age) were assessed.
- Statistical analysis included Chi-squared tests and unpaired t-tests.
Main Results:
- The comprehensive care clinic group showed significantly higher rates of catch-up growth for length and head circumference at 8 and 12 months corrected age.
- At 12 months corrected age, 87% of comprehensive care infants achieved >= 5th percentile for length vs. 57% in the general pediatric group (P < .05).
- At 12 months corrected age, 90% of comprehensive care infants achieved >= 5th percentile for head circumference vs. 52% in the general pediatric group (P < .05).
Conclusions:
- Multidisciplinary primary care incorporating registered dietitian services significantly enhances catch-up growth in VLBW infants.
- Routine nutrition intervention within a comprehensive care model is effective in improving growth outcomes for VLBW infants up to 12 months corrected age.
- This approach supports better physical development for high-risk neonates.
Objective:
To determine the impact of multidisciplinary primary care follow-up, which included the services of a registered dietitian, on growth outcomes of very-low-birth-weight (VLBW) infants.
Design:
Data were obtained retrospectively from medical records. Forty-two infants receiving follow-up care on an as needed basis from the general pediatric clinic were compared with 33 infants receiving multidisciplinary follow-up care that included routine nutrition intervention from the comprehensive care clinic. Comparisons were made in weight, length, and head circumference measurements; growth rates; and catch-up growth (defined as > or = 5th percentile on growth charts of the National Center for Health Statistics attained by 12 months growth-corrected age).
Subjects:
VLBW infants (< or = 1,500 g at birth) were selected from both follow-up groups.
Statistical Analysis:
Chi 2 Analysis compared the proportions of infants in each group who achieved catch-up growth. Unpaired t tests compared group means in weight, length, and head circumference measurements and growth rates.
Results:
The two groups differed significantly in the number of infants exhibiting catch-up growth for length and head circumference. At 8 months growth-corrected age, 7 (28%) of the general pediatric clinic infants were at the 5th percentile or greater for length compared with 21 (64%) of the comprehensive care clinic infants (P < .01); 15 (60%) of the general pediatric clinic group and 30 (91%) of the comprehensive care clinic group were at the 5th percentile or greater for head circumference (P < .05). At 12 months growth-corrected age, 12 (57%) of the general pediatric clinic infants and 26 (87%) of the comprehensive care clinic infants were at the 5th percentile or greater for length (P < .05); 11 (52%) of the general pediatric clinic infants and 27 (90%) of the comprehensive care clinic infants were at the 5th percentile or greater for head circumference (P < .05).
Applications:
Multidisciplinary primary care follow-up that includes the services of a registered dietitian for nutrition intervention can enhance the catch-up growth of VLBW infants through 12 months growth-corrected age.