Applying Methods for Postnatal Growth Assessment in the Clinical Setting: Evaluation in a Longitudinal Cohort of Very Preterm Infants

• Published in: Nutrients Vol. 11; no. 11; p. 2772
• Main Authors: Izquierdo Renau, Montserrat, Aldecoa-Bilbao, Victoria, Balcells Esponera, Carla, Del Rey Hurtado de Mendoza, Beatriz, Iriondo Sanz, Martin, Iglesias-Platas, Isabel
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 14.11.2019; MDPI
• Subjects: Age; Anthropometry; Babies; Birth weight; Body Height; Body Weight; Carbohydrates; Clinical medicine; Cohort Studies; Failure to Thrive - diagnosis; Failure to Thrive - therapy; Female; Fetal Growth Retardation; Gestational Age; Growth Disorders - diagnosis; Growth Disorders - therapy; Health risk assessment; Humans; Infant; Infant Nutrition Disorders - diagnosis; Infant Nutrition Disorders - therapy; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases - diagnosis; Infant, Premature, Diseases - therapy; Infant, Very Low Birth Weight; Infants; Intensive Care Units, Neonatal; Length of Stay; Lipids; Logistic Models; Longitudinal Studies; Male; Milk; Newborn babies; Nutrition; Nutrition Assessment; Nutritional Status; Oxygen; Parenteral Nutrition; Pediatrics; Physical growth; Premature babies; Proteins; Velocity; Weight Loss; Spain; intrauterine growth restriction; extrauterine growth restriction; fall in z-score; postnatal growth failure
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu11112772

To analyze different methods to assess postnatal growth in a cohort of very premature infants (VPI) in a clinical setting and identify potential early markers of growth failure. Study of growth determinants in VPI (≤32 weeks) during hospital stay. Nutritional intakes and clinical evolution were recorded. Growth velocity (GV: g/kg/day), extrauterine growth restriction (%) (EUGR: weight < 10th centile, -score < -1.28) and postnatal growth failure (PGF: fall in -score > 1.34) at 36 weeks postmenstrual age (PMA) were calculated. Associations between growth and clinical or nutritional variables were explored (linear and logistic regression). Sample: 197 VPI. GV in IUGR patients was higher than in non-IUGRs (28 days of life and discharge). At 36 weeks PMA 66.0% of VPIs, including all but one of the IUGR patients, were EUGR. Prevalence of PGF at the same time was 67.4% (IUGR patients: 48.1%; non-IUGRs: 70.5% ( = 0.022)). Variables related to PGF at 36 weeks PMA were initial weight loss (%), need for oxygen and lower parenteral lipids in the first week. The analysis of -scores was better suited to identify postnatal growth faltering. PGF could be reduced by minimising initial weight loss and assuring adequate nutrition in patients at risk.