Extra-uterine growth restriction in very low birth weight infants

Extrauterine growth restriction (EUGR) affects a significant number of very low birth weight (VLBW) infants and has the potential to impact neurodevelopmental outcome as well as other aspects of long-term health. More aggressive nutritional approaches have reduced the incidence of postnatal growth failure but many questions remain about the expected rate of growth for very preterm infants, the best ways to measure growth velocity, and the optimal approaches to supporting growth. This article examines some of the outstanding issues regarding postnatal growth failure and summarizes current practice recommendations.

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P301 EARLY GROWTH RESTRICTION AMONG VERY LOW BIRTH WEIGHT INFANTS INCREASES CATCH-UP GROWTH THE FIRST YEAR OF LIFE

Clinical Nutrition Supplements ◽

10.1016/s1744-1161(09)70351-5 ◽

2009 ◽

Vol 4 (2) ◽

pp. 152

Author(s):

A.C. Westerberg ◽

C. Henriksen ◽

A. Ellingvåg ◽

M. Veierød ◽

P. Juliusson ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Early Growth ◽

Growth Restriction ◽

First Year ◽

Low Birth Weight Infants ◽

Catch Up ◽

First Year Of Life

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Growth and nutrient intake among very-low-birth-weight infants fed fortified human milk during hospitalisation

British Journal Of Nutrition ◽

10.1017/s0007114509371755 ◽

2009 ◽

Vol 102 (8) ◽

pp. 1179-1186 ◽

Cited By ~ 55

Author(s):

Christine Henriksen ◽

Ane C. Westerberg ◽

Arild Rønnestad ◽

Britt Nakstad ◽

Marit B. Veierød ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Human Milk ◽

Preterm Infants ◽

Nutrient Intake ◽

Very Low Birth Weight ◽

Growth Restriction ◽

Vlbw Infants ◽

Uterine Growth ◽

Discharge From Hospital

Postnatal growth failure in preterm infants is due to interactions between genetic and environmental factors, which are not fully understood. We assessed dietary supply of nutrients in very-low-birth-weight (VLBW, < 1500 g) infants fed fortified human milk, and examined the association between nutrient intake, medical factors and growth during hospitalisation lasting on average 70 d. We studied 127 VLBW infants during the early neonatal period. Data were obtained from medical records on nutrient intake, growth and growth-related factors. Extra-uterine growth restriction was defined as body weight < 10th percentile of the predicted value at discharge. Using logistic regression, we evaluated nutrient intake and other relevant factors associated with extra-uterine growth restriction in the subgroup of VLBW infants with adequate weight for gestational age at birth. The proportion of growth restriction was 33 % at birth and increased to 58 % at discharge from hospital. Recommended values for energy intake (>500 kJ/kg per d) and intra-uterine growth rate (15 g/kg per d) were not met, neither in the period from birth to 28 weeks post-conceptional age (PCA), nor from 37 weeks PCA to discharge. Factors negatively associated with growth restriction were energy intake (Ptrend = 0·002), non-Caucasian ethnicity (P = 0·04) and weight/predicted birth weight at birth (Ptrend = 0·004). Extra-uterine growth restriction is common in VLBW infants fed primarily fortified human milk. Currently recommended energy and nutrient intake for growing preterm infants was not achieved. Reduced energy supply and non-Caucasian ethnicity were risk factors for growth restriction at discharge from hospital.

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Nutritional Factors Associated with Late-Onset Sepsis in Very Low Birth Weight Newborns

Nutrients ◽

10.3390/nu14010196 ◽

2021 ◽

Vol 14 (1) ◽

pp. 196

Author(s):

Juliany Caroline Silva de Sousa ◽

Ana Verônica Dantas de Carvalho ◽

Lorena de Carvalho Monte de Prada ◽

Arthur Pedro Marinho ◽

Kerolaynne Fonseca de Lima ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Enteral Nutrition ◽

Parenteral Nutrition ◽

Very Low Birth Weight ◽

Late Onset ◽

Growth Restriction ◽

Low Birth Weight Infants ◽

Late Onset Sepsis ◽

Extrauterine Growth Restriction

Background: Delayed onset of minimal enteral nutrition compromises the immune response of preterm infants, increasing the risk of colonization and clinical complications (e.g., late-onset sepsis). This study aimed to analyze associations between late-onset sepsis in very low birth weight infants (<1500 g) and days of parenteral nutrition, days to reach full enteral nutrition, and maternal and nutritional factors. Methods: A cross-sectional study was carried out with very low birth weight infants admitted to a neonatal intensive care unit (NICU) of a reference maternity hospital of high-risk deliveries. Data regarding days of parenteral nutrition, days to reach full enteral nutrition, fasting days, extrauterine growth restriction, and NICU length of stay were extracted from online medical records. Late-onset sepsis was diagnosed (clinical or laboratory) after 48 h of life. Chi-squared, Mann–Whitney tests, and binary logistic regression were applied. Results: A total of 97 preterm infants were included. Of those, 75 presented late-onset sepsis with clinical (n = 40) or laboratory (n = 35) diagnosis. Maternal urinary tract infection, prolonged parenteral nutrition (>14 days), and extrauterine growth restriction presented 4.24-fold, 4.86-fold, and 4.90-fold higher chance of late-onset sepsis, respectively. Conclusion: Very low birth weight infants with late-onset sepsis had prolonged parenteral nutrition and took longer to reach full enteral nutrition. They also presented a higher prevalence of extrauterine growth restriction than infants without late-onset sepsis.

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