“Extrauterine growth restriction” and “postnatal growth failure” are misnomers for preterm 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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Disrupted Maturation of the Microbiota and Metabolome among Extremely Preterm Infants with Postnatal Growth Failure

Scientific Reports ◽

10.1038/s41598-019-44547-y ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 13

Author(s):

Noelle E. Younge ◽

Christopher B. Newgard ◽

C. Michael Cotten ◽

Ronald N. Goldberg ◽

Michael J. Muehlbauer ◽

...

Keyword(s):

Preterm Infants ◽

Growth Failure ◽

Postnatal Growth ◽

Extremely Preterm ◽

Extremely Preterm Infants ◽

Postnatal Growth Failure

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Prenatal intrauterine growth restriction and risk of retinopathy of prematurity

Scientific Reports ◽

10.1038/s41598-020-74600-0 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Alison Chu ◽

Yasmeen Dhindsa ◽

Myung Shin Sim ◽

Marie Altendahl ◽

Irena Tsui

Keyword(s):

Gestational Age ◽

Retinopathy Of Prematurity ◽

Intrauterine Growth Restriction ◽

Growth Failure ◽

Postnatal Growth ◽

Growth Patterns ◽

Growth Restriction ◽

Intrauterine Growth ◽

Prenatal Growth ◽

Postnatal Growth Failure

Abstract Low birthweight and decreased postnatal weight gain are known predictors of worse retinopathy of prematurity (ROP) but the role of prenatal growth patterns in ROP remains inconclusive. To distinguish small for gestational age (SGA) from intrauterine growth restriction (IUGR) as independent predictors of ROP, we performed a retrospective cohort study of patients who received ROP screening examinations at a level IV neonatal intensive care unit over a 7-year period. Data on IUGR and SGA status, worst stage of and need for treatment for ROP, and postnatal growth was obtained. 343 infants were included for analysis (mean gestational age = 28.6 weeks and birth weight = 1138.2 g). IUGR infants were more likely to have a worse stage of ROP and treatment-requiring ROP (both p < 0.0001) compared to non-IUGR infants. IUGR infants were more likely to be older at worst stage of ROP (p < 0.0001) and to develop postnatal growth failure (p = 0.01) than non-IUGR infants. Independent of postnatal growth failure status, IUGR infants had a 4–5 × increased risk of needing ROP treatment (p < 0.001) compared to non-IUGR infants. SGA versus appropriate for gestational age infants did not demonstrate differences in retinopathy outcomes, age at worst ROP stage, or postnatal growth failure. These findings emphasize the importance of prenatal growth on ROP development.

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Do Pre- and Postnatal Growth Failure Increase the Severity of Bronchopulmonary Dysplasia or Pulmonary Hypertension in Preterm Infants?

Journal of the Academy of Nutrition and Dietetics ◽

10.1016/j.jand.2017.06.239 ◽

2017 ◽

Vol 117 (9) ◽

pp. A22

Author(s):

L. Lamport ◽

I. Gershkovich ◽

M. Ahmed ◽

B. Weinberger ◽

R. Schanler

Keyword(s):

Pulmonary Hypertension ◽

Preterm Infants ◽

Bronchopulmonary Dysplasia ◽

Growth Failure ◽

Postnatal Growth ◽

Postnatal Growth Failure

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Causes of Postnatal Growth Failure in Preterm Infants

Perinatal Growth and Nutrition ◽

10.1201/b16896-8 ◽

2014 ◽

pp. 58-77 ◽

Cited By ~ 1

Keyword(s):

Preterm Infants ◽

Growth Failure ◽

Postnatal Growth ◽

Postnatal Growth Failure

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Postnatal growth failure in preterm infants: Recovery of growth and body composition after term

Early Human Development ◽

10.1016/j.earlhumdev.2008.01.012 ◽

2008 ◽

Vol 84 (8) ◽

pp. 555-559 ◽

Cited By ~ 17

Author(s):

Paola Roggero ◽

Maria Lorella Giannì ◽

Orsola Amato ◽

Anna Orsi ◽

Pasqua Piemontese ◽

...

Keyword(s):

Body Composition ◽

Preterm Infants ◽

Growth Failure ◽

Postnatal Growth ◽

Postnatal Growth Failure

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Plasma Metabolome Alterations Associated with Extrauterine Growth Restriction

Nutrients ◽

10.3390/nu12041188 ◽

2020 ◽

Vol 12 (4) ◽

pp. 1188

Author(s):

Danuta Dudzik ◽

Isabel Iglesias Platas ◽

Montserrat Izquierdo Renau ◽

Carla Balcells Esponera ◽

Beatriz del Rey Hurtado de Mendoza ◽

...

Keyword(s):

Preterm Infants ◽

Growth Failure ◽

Growth Restriction ◽

Plasma Metabolites ◽

Very Preterm Infants ◽

Adverse Health Outcomes ◽

Plasma Metabolome ◽

Definition Of ◽

Extrauterine Growth Restriction ◽

Gestational Age At Birth

Very preterm infants (VPI, born at or before 32 weeks of gestation) are at risk of adverse health outcomes, from which they might be partially protected with appropriate postnatal nutrition and growth. Metabolic processes or biochemical markers associated to extrauterine growth restriction (EUGR) have not been identified. We applied untargeted metabolomics to plasma samples of VPI with adequate weight for gestational age at birth and with different growth trajectories (29 well-grown, 22 EUGR) at the time of hospital discharge. A multivariate analysis showed significantly higher levels of amino-acids in well-grown patients. Other metabolites were also identified as statistically significant in the comparison between groups. Relevant differences (with corrections for multiple comparison) were found in levels of glycerophospholipids, sphingolipids and other lipids. Levels of many of the biochemical species decreased progressively as the level of growth restriction increased in severity. In conclusion, an untargeted metabolomic approach uncovered previously unknown differences in the levels of a range of plasma metabolites between well grown and EUGR infants at the time of discharge. Our findings open speculation about pathways involved in growth failure in preterm infants and the long-term relevance of this metabolic differences, as well as helping in the definition of potential biomarkers.

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