Association of early postnatal growth trajectory with body composition in term low birth weight infants

Growth acceleration or catch-up growth (CUG) in early infancy is a plausible risk factor for later obesity and cardiovascular disease. We postulate that this risk may be mediated by an adverse programming of body composition by CUG in early infancy. The study was aimed at evaluating the association between the pattern of gain in weight and length of term low birth weight (LBW) infants from birth to 6 months, with fat mass percent (FM%) at 6 months. Term healthy singleton LBW infants were enrolled. Baby’s weight and length z-scores were measured at birth and three follow-up visits. Body composition was measured by dual-energy absorptiometry at last visit. A total of 54 babies (28 boys) were enrolled. The mean birth weight and gestation were 2175±180 g and 37.6±0.6 weeks. Follow-up visits were at 1.4±0.0, 3.0±0.3 and 7.2±0.8 months. The proportion of babies who showed CUG [increase in weight for age z-score (∆WAZ)>0.67] from birth to 1.4, 3.0 and 7.2 months was 29.6, 26.4 and 48.5%, respectively. The mean FM% at 7.2 months was 16.6±7.8%. Infants with greater ∆WAZ from birth to 3 and 7.2 months had significantly greater FM% at 7.2 months after adjusting for current age, size and gender. Infants with early CUG (<1.4 months) had higher FM% than infants with no CUG. We conclude that earlier and greater increment in WAZ is positively associated with FM%.

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Nutritional Balance Studies in Very-Low-Birth-Weight Infants: Enhanced Nutrient Retention Rates by an Experimental Formula

PEDIATRICS ◽

10.1542/peds.66.2.233 ◽

1980 ◽

Vol 66 (2) ◽

pp. 233-238

Author(s):

Jayant P. Shenai ◽

John W. Reynolds ◽

S. Gorham Babson

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Oral Intake ◽

Nutrient Retention ◽

Postnatal Growth ◽

Retention Rates ◽

Low Birth Weight Infants ◽

Accretion Rates ◽

The Mean

An experimental infant formula developed to meet the specific nutritional needs of very-low-birth-weight infants was evaluated by 96-hour balance studies in ten preterm infants (birth weight: 1,130 to 1,530 gm). The formula contained 23.2 gm/liter of protein (whey protein/casein ratio, 60:40), 44.1 gm/liter of fat (50% medium-chain triglycerides) and 85.0 gm/liter of carbohydrate (50% lactose, 50% Polycose), and provided relatively higher amounts of calcium, phosphorus, vitamin D, and electrolytes than are in human milk. All infants were fed 150 ml/kg/day (120 calories/kg/day) by intermittent gavage. Balance studies were carried out nine days following establishment of oral intake. The mean (±SEM) nutrient retention rates revealed by balance studies in these infants (calcium, 170 ± 4 mg/kg/day; phosphorus, 78 ± 3 mg/kg/day; nitrogen, 426 ± 8 mg/kg/day; sodium, 1.4 ± 0.1 mEq/kg/day) were comparable to normal fetal accretion rates. The mean (±SEM) fat absorption was 92.5 ± 0.9%. No clinical intolerances or biochemical abnormalities were observed, and adequate postnatal growth was achieved in all infants. The diet proved to be nutritionally advantageous and safe for very-low-birth-weight infants.

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Neurodevelopmental outcome in extremely low birth weight infants in Johannesburg, South Africa

10.21203/rs.3.rs-31866/v1 ◽

2020 ◽

Author(s):

Tanusha Ramdin ◽

Yoliswa Magadla ◽

Robin T Saggers ◽

Aripfani Veronica Mphaphuli ◽

Rossella M Bandini ◽

...

Keyword(s):

South Africa ◽

At Risk ◽

Cerebral Palsy ◽

Birth Weight ◽

Low Birth Weight ◽

Subscale Score ◽

Extremely Low Birth Weight ◽

Low Birth Weight Infants ◽

The Mean

Abstract Background: Improved survival in preterm infants whether due to technological progress or treatment like antenatal steroids, surfactant administration or nasal continuous positive airway pressure (NCPAP) and aggressive resuscitation have raised the question about whether the survivors would be more prone to increased morbidity and adverse neurodevelopmental disability. Methods: This was a prospective follow-up study conducted in the neonatal unit of a tertiary hospital in Johannesburg, South Africa. Bayley scales of infant and toddler development, version III, were conducted on a group of extreme low birth weight infants (ELBWI). The mean composite cognitive, language and motor sub-scales were reported. Infants were considered to be “at risk” if the composite subscale score was below 85 and “disabled” if the composite subscale score was below 70. Infants identified with cerebral palsy were also reported.Results: The mean birth weight of the study group was 858.5grams (95% CI 839.2- 877.8) and the mean gestational age was 27.5 weeks (95% CI 27.1-27.9). The majority of ELBWI enrolled in the study had at least one Bayley at a mean corrected age of 17.09 months (CI 16.04 to 18.14). The mean composite scores for cognition were 98.4 (CI 95.1-101.7), language 90.0 (CI 87.5-92.6) and motor 97.9 (CI 94.8-101.0). All mean scores fell within the normal range, but the composite language score was the lowest. The study did not diagnose cerebral palsy in any of the infants. The study found 28 (36.3%) infants to be “at risk” for neurodevelopmental delay. Significantly more males were classified as “at risk” than females (13/25 (52%) vs. 15/52 (28.8%). Late onset sepsis (sepsis18/37 (48.6%) vs. no sepsis 10/40 (25%) p=0.031) and longer duration of ventilation (median of 12 days (IQR 46) vs. median of 4.0 days (IQR 5) p=0.048) were significantly associated with an “at risk” classification. Conclusion: Rates of early neurodevelopmental impairment have altered minimally despite significant improvements in the overall survival of ELBWI. It is of paramount importance to ensure that early neurodevelopmental outcomes are accurately assessed so as to assist doctors and families in establishing a foundation for advocacy for the immediate intensive care and post discharge follow up.

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