Early growth of preterm infants with prolonged hospitalisation

• Published in: Singapore medical journal Vol. 53; no. 12; pp. 832 - 839
• Main Authors: RU, Xi-Fang, QI FENG, YING WANG, XIN ZHANG, XING LI, MENG, Jing-Wen, GUO, Zai-Chen
• Format: Journal Article
• Language: English
• Published: Singapore Singapore Medical Association 01.12.2012
• Subjects: Biological and medical sciences; Diseases of mother, fetus and pregnancy; Female; Follow-Up Studies; General aspects; Gestational Age; Growth Disorders - epidemiology; Growth Disorders - etiology; Gynecology. Andrology. Obstetrics; Humans; Incidence; Infant, Newborn; Infant, Premature - growth & development; Infant, Premature, Diseases - epidemiology; Infant, Premature, Diseases - etiology; Length of Stay - trends; Male; Medical sciences; Pregnancy; Pregnancy. Fetus. Placenta; Retrospective Studies; Singapore - epidemiology; Singapore; Human; Premature; follow-up; Prematurity; Growth; Body weight; preterm; Tropical medicine; Infant; Corporal biometry; body weight Z-score; underweight
• ISSN: 0037-5675

This study aimed to determine the early growth patterns of preterm infants who required prolonged hospitalisation in terms of body weight Z-score, and to explore the influencing factors and predictors of their growth. The criteria of enrolment included preterm birth, singleton pregnancy, hospitalisation within the first 24 hours of life, hospital stay ≥ 28 days and clinical follow-up beyond 91 days of corrected age. Body weight Z-scores and the incidence of underweight infants were reviewed periodically, and the influencing factors and possible predictors of growth analysed. Body weight Z-scores of all infants of gestational age (GA) groups kept decreasing, with a trough seen at 36 weeks corrected gestational age (CGA). At corrected full-term, body weight Z-scores for all birth weight groups achieved birth level and were higher than that at 36 weeks CGA. Body weight Z-scores at 61 days corrected age was (-0.300 × GA [weeks] + 0.210 × birth weight [g] + 0.682 × body weight Z-score) at 40 weeks CGA. The cut-off values for body weight Z-score at birth (cut-off, -1.79; sensitivity, 100%; specificity, 91.3%) and 61 days corrected age (cut-off, -1.95; sensitivity, 100%; specificity, 97.1%) were selected to predict the risk of being underweight at 183 days corrected age. Early growth restriction is a practical problem in preterm infants with prolonged hospitalisation. Body weight Z-scores at 40 weeks CGA and 61 days corrected age can be used to predict body weight gain prior to 183 days corrected age in these infants.