scholarly journals Umbilically and Peripherally Inserted Thin Central Venous Catheters Have Similar Risks of Complications in Very Low Birth Weight Infants

2021 ◽  
Author(s):  
S Salonen ◽  
O Tammela ◽  
AM Koivisto ◽  
P Korhonen
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Umbilical Vein ◽  
Multivariable Analysis ◽  
Hospital Data ◽  
Vlbw Infants ◽  
Catheter Infection ◽  
Catheter Complications

Abstract In order to compare the complications associated with thin (1-2F) umbilical vein catheters (tUVC) and peripherally inserted central catheters (PICC) in very low birth weight (VLBW) infants, the frequencies and causes of the non-elective removal of first tUVCs and PICCs were evaluated in 195 VLBW infants born in one hospital. Data were collected from patient records. Risk factors for catheter complications were analysed using logistic regression analysis. Altogether, 92 (47%) infants had tUVCs, and 103 (53%) PICCs. In total, 78 (40%) infants underwent the non-elective removal of their first catheters, most commonly due to suspected infection (n=42) or catheter dislocation (n=30). Infants with complications had lower birth weights and gestational ages than those without. The frequencies and causes of the non-elective catheter removal were similar in the tUVC and PICC groups. True catheter infection was diagnosed in 31 infants. The number of infections/1,000 catheter days was higher in the tUVC than in the PICC group. In a multivariable analysis, gestational age was found to be associated with catheter infection, but catheter type was not. Conclusion: The odds of catheter complications seem to decrease with increasing gestational age, but no clear association with thin catheter type was found.

Pre-discharge growth pattern of very low birth weight infants (VLBW): A 5 year single center experience

2020 ◽  
pp. 1-6
Author(s):  
S.H. Elbeely ◽  
M.A. AlQurashi
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Growth Pattern ◽  
Very Low Birth Weight ◽  
Single Center ◽  
Low Birth Weight Infants ◽  
Cross Sectional ◽  
Vlbw Infants ◽  
The Mean

BACKGROUND: Very low birth weight infants born prematurely are at greater risk for growth delays that lead to Ex-utero Growth Restriction (EUGR) during vulnerable periods of organ structural and functional development. There is considerable evidence that early growth failure has adverse effects on long term neurodevelopment in children which often persists into adulthood. METHODS: This is a single-center cross-sectional study on live newborn infants with birth weight ranges from 500 to 1500 grams (VLBW) and gestational age (GA) between 24–32 weeks who were admitted to NICU at KAMC-Jeddah over a 5 year period (2009–2013). This study aims to evaluate predischarge growth pattern of VLBW infants in terms of weight, head circumference (HC) and length and to identify important variables that have influenced such growth pattern. RESULTS: Of the 135 infants included in the final analysis, 68 (50.4%) were male and 67 (49.6%) were female and the mean gestational age was 28.83±2.064 weeks and the mean birth weight 1166.74±256 grams. Ninety-two infants (68%) had discharge weight at ≤10th percentile and forty four (32%) had their weight >10th percentile. HC was the lowest affected among the anthropometric measurements with 42% ≤10th percentile. In terms of linear growth, 62% had their length ≤10th percentile. Amongst infants born ≤750 grams, 71% and 70% had HC and height at ≤10th percentile respectively, at the time of discharge. BPD was significantly associated with EUGR (p = 0.026). CONCLUSIONS: This study demonstrates that almost 2/3rd of VLBW infants born at KAMC-Jeddah with birth weight ≤750 grams were discharged home with EUGR as demonstrated by their weight, length, and HC ≤10th percentile. BPD was found to be significantly associated with EUGR amongst post-natal factors influencing EUGR.

scholarly journals 39 Early Higher Parenteral Lipid Intake Decreases Extra-Uterine Growth Restriction in Very Low Birth weight Infants: A Randomized Controlled Trial

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e15-e16
Author(s):  
Wissam Alburaki ◽  
Belal Alshaikh ◽  
Kamran Yusuf
Keyword(s):  
Weight Loss ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Intervention Group ◽  
Excessive Weight Loss ◽  
Vlbw Infants ◽  
Excessive Weight ◽  
Uterine Growth

Abstract Background Approximately 43-65% of very low birth weight (VLBW) infants develop extra-uterine growth restriction (EUGR). EUGR is associated with a significant increase in the risk of neurodevelopmental impairment. Inadequate early postnatal nutrition results in excessive weight loss that cannot be explained by the physiologic contraction of body water alone. EUGR and postnatal growth failure are usually associated with negative early energy and nitrogen balance in the first week of life. Growth trajectories after initial weight loss have similar slopes regardless of gestational age, which indicates that the early excessive weight loss is a lead cause for EUGR. Objectives To study whether an early and higher parenteral lipid intake in the first week after birth would decrease the percentage of weight loss and subsequently the incidence of EUGR. Design/Methods This was a randomized, open-label, control trial of appropriate-for-gestational age VLBW infants admitted to our level III NICU. Lipid intake in the control group started at 0.5-1 g/kg/day and was increased daily by 0.5-1 g/kg/day until 3 g/kg/day was reached. The intervention group was started on 2 g/kg/day then increased to 3 g/kg/day the following day. Triglyceride levels were measured the day after the start and after each increase in lipid intake. Results Among the 176 infants assessed for eligibility, eighty-three were included in the trial. There were no significant differences between the control and the intervention group in mean gestational age (27.3 ± 2.4 vs. 27.1 ± 2.3 weeks respectively) or birth weight (1011 ± 250 vs. 1019 ± 271 g respectively). Infants in the intervention group were started on lipid earlier (13.8±7.8 vs. 17.5±7.8 h; p=0.03) and had higher cumulative lipid intake in the first 7 days of age (13.5±4.2 vs. 10.9±3.5 g/kg; p=0.004) that led to a protein to energy ratio; closer to the recommended values. Total fluid intake was similar between the two groups. Infants in the intervention group had a lower percentage of weight loss (10.4±3.6 vs. 12.7±4.6; p=0.02). The mean triglyceride level was higher in the intervention group (1.91± 0.79 vs. 1.49±0.54 mmol/L; p= 0.01), however, hypertriglyceridemia was similar between the two groups at 2 and 3 g/kg/day of lipid intake. Enteral energy and protein intake calculated weekly between the time of parenteral nutrition discontinuation and 36 weeks corrected gestational age (CGA) were similar between the 2 groups. EUGR at 36 weeks CGA was significantly lower in the intervention group (38.6% vs. 67.6%; p=0.01). Conclusion In VLBW infants, the provision of an early and higher dose of parenteral lipid in the first week of life results in less weight loss and lower incidence of EUGR.

scholarly journals Influence of the level of maternal education on the long-term neurodevelopmental outcome of Saudi infants with birth weight of 1000-1500 grams at the age of 21-24 months

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Badr Hasan Sobaih
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Maternal Education ◽  
Very Low Birth Weight ◽  
Neurodevelopmental Outcome ◽  
University Hospital ◽  
Vlbw Infants

Background: Advancements in perinatal-neonatal care in the last decades has led to improved survival rates of very-low birth weight (VLBW) infants. An association between the level of maternal education and neurodevelopmental outcome has been demonstrated in many European studies. This study evaluates the influence of maternal education level and socio-demographic status on the long-term development of Saudi VLBW infants with birth weight of 1000-1500 grams at a corrected gestational age of 21-24 months. Method: This retrospective cohort study examined prospectively collected data from the period of 2005 to 2016 from the Neonatal Follow-up Program (NFP) at King Khalid University Hospital in Riyadh, Saudi Arabia. Results: A total of 122 VLBW infants with a mean gestational age of 29.57 weeks and mean birth weight 1265 grams were enrolled. There was no statistically significant association between the level of maternal education and neurodevelopmental screening outcome at the age of 21-24 months according to the Bayley Infant Neurodevelopmental Screener (BINS) (p=0.149). Bronchopulmonary dysplasia (BPD) was highly associated with cerebral palsy (p=0.001) and an abnormal BINS score (p=0.010). Conclusion: There was no significant influence of the level of maternal education on the neurodevelopmental screening outcome of VLBW infants at the corrected age of 21-24 months. BPD was the strongest predictor of adverse neurodevelopmental outcome. Keywords: Bayley Infant Neurodevelopmental Screener (BINS), Neurodevelopmental Outcome, Maternal educational level, Neonatal follow-up program (NFP), Very Low Birth Weight (VLBW) infant.

scholarly journals Predictors of early growth failure in preterm, very low birth weight infants during hospitalization

2019 ◽  
Vol 59 (1) ◽  
pp. 44-50
Author(s):  
Noviyani Leksomono ◽  
Retno Sutomo ◽  
Ekawaty Lutfia Haksari
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Respiratory Distress ◽  
Gestational Age ◽  
Medical Records ◽  
Very Low Birth Weight ◽  
Growth Parameters ◽  
Growth Failure ◽  
Early Growth ◽  
Vlbw Infants

Background Preterm, very low birth weight (VLBW) infants experience intrauterine nutritional deficits and perinatal comorbidities that may impair early growth parameters. Early growth failure has detrimental effects on later growth and neurodevelopment in childhood. Objective To analyze predictors of early growth failure in preterm, VLBW infants and differences in early growth parameters between small-for-gestational age (SGA) and appropriate-for-gestational age (AGA) infants. Methods This retrospective cohort study was conducted at Dr. Sardjito Hospital, Yogyakarta from 2011 to 2016. Subjects were preterm infants, with birth weights of 1,000-1,499 g. Twins, those who died during hospitalization, were discharged against medical advice, or had incomplete medical records were excluded. Adequate intrauterine growth was determined by the Lubchenco table criteria. Growth parameters and perinatal comorbidities were collected from medical records. Growth failure was defined as discharge weight less than 10th percentile of the Fenton growth curve. Bivariate and multivariate analysis were used to analyze potential predictive factors of early growth failure. Results Of 646 preterm, VLBW infants during the study period, 398 were excluded. Respiratory distress and SGA were predictors of early growth failure (AOR 6.94; 95%CI 2.93 to 16.42 and AOR 34.44; 95%CI 7.79 to 152.4, respectively). Mean weight velocities in SGA and AGA infants were not significantly different [16.5 (SD 5.9) and 17.5 (SD 5.3) g/kg/day, respectively; (P=0.25)]. Median time to regain, time to reach full feeding, and time to reach 120 kcal/kg/day were also not significantly different between SGA and AGA infants. Conclusions SGA and respiratory distress are predictors of early growth failure in preterm, VLBW infants during hospitalization. The SGA infants grow slower than AGA infants.

scholarly journals Growth of preterm very low birth weight infants discharged with weight of less than 1500grams

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yaser Abdallah ◽  
Flavia Namiiro ◽  
Jolly Nankunda ◽  
Jamiru Mugalu ◽  
Yvonne Vaucher
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Growth Velocity ◽  
Very Low Birth Weight ◽  
Growth Failure ◽  
Average Weight ◽  
High Risk Population ◽  
Post Discharge ◽  
Vlbw Infants

Abstract Early discharge of preterm very low birth weight (VLBW) infants is at times inevitable in low resource settings. The implication of such practice on the growth of this high-risk population is not known. We conducted a retrospective chart review to describe the growth of preterm VLBW infants discharged with a weight of less than 1500 g. Objectives To describe the growth of discharged preterm VLBW infants over the first 12 weeks. Method Between June 2013 and January 2014; 164 discharged preterm VLBW infants were followed up for 3 months. Among the survivors (132), we identified 111 infant records for this study. Relevant data was entered in STATA for analysis. Growth percentiles were determined at approximately 4 weeks, 8 weeks, and 12 weeks post-discharge using the intergrowth 21st growth charts. Growth velocities were computed using the 2-point average weight model. Regression analysis was used to identify factors associated with growth failure. Growth failure was defined as occipital frontal circumference (OFC), weight, and length < 10th centile by 12 weeks post-discharge. P-value of < 0.05 was considered significant at a 95% confidence interval. Results Among the study infants the median gestational age and weight at birth were 32 weeks (range 28-35 weeks) and 1250 g(range 850-1500 g) respectively; 60/111(54%) were Small for Gestational Age (SGA). The median discharge postmenstrual age (PMA) was 34 weeks (range 30-38 weeks) and weight was 1140 g (range 830-1490 g). The majority 88.2% had not recovered birth weight at discharge of whom 59.1% recovered by 2 weeks and 40.9% recovered between 2 and 4 weeks after discharge. By 12 weeks post-discharge the median PMA and weight were 46 weeks (range 37-51 weeks),and 3110 g (range 1750-5000 g) respectively, 38.7% of the infants had growth failure and 36.9% had OFC <3rd centile. Growth velocity < 15 g/kg/d in the first 4 weeks (OR 3.8, p 0.010) and subsequent 4 weeks (OR 2.5, p 0.049) post-discharge were independently associated with growth failure. Conclusion Slow birth weight recovery was observed and growth failure was prevalent by 12 weeks post-discharge with more than a third having severe microcephaly. Poor post-discharge growth velocity was associated with subsequent growth failure. Recommendations Growth velocity monitoring among preterm VLBW infants should be emphasized. The implication and interventions of this early growth failure needs to be explored.

scholarly journals The role of serum and urinary urea in the evaluation of enteral protein intake in adequate and small-for-gestational-age very low birth weight infants

2005 ◽  
Vol 123 (6) ◽  
pp. 261-265
Author(s):  
Silvana Darcie ◽  
Cléa Rodrigues Leone
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Protein Intake ◽  
Very Low Birth Weight ◽  
Pearson Correlation ◽  
Serum Urea ◽  
Low Birth Weight Infants ◽  
Vlbw Infants

CONTEXT AND OBJECTIVE: Very low birth weight (VLBW) infants have special nutritional needs. There is a current tendency to individualize their protein needs. The objective of this study was to determine the suitability of serum and urinary urea as indicators for protein intake in adequate-for-gestational-age (AGA) and small-for-gestational-age (SGA) VLBW infants. DESIGN AND SETTING: Prospective study in the nursery attached to the Maternity Ward of the "Prof. Pedro de Alcântara" Children's Institute, Hospital das Clínicas, Department of Pediatrics, Faculdade de Medicina da Universidade de São Paulo, Brazil. METHODS: Seventy-two VLBW infants (mean protein intake = 3.7 mg/kg/day) were enrolled in a prospective cohort study in two groups: AGA (n = 34) and SGA (n = 38). Blood samples, six-hour urine (6hUr) collections and urine sample tests (STUr) were obtained for urea and creatinine assays at three and five weeks of life. Statistical analysis: Student's t test, Pearson correlation and linear regression (p < 0.05). RESULTS: There were no differences between groups for serum urea, 6hUr and STUr, or between two assessments within each group. Serum urea correlated with 6hUr in both AGA and SGA, and to STUr in SGA; 6hUr correlated with STUr in both AGA and SGA. There was no correlation between protein intake and serum or urine urea. CONCLUSIONS: Serum and urinary urea did not reflect protein intake when mean intakes of 3.7 g/kg/day were used. Sample tests of urinary urea can be as reliable as urea from urine collected over longer periods.

scholarly journals Morbidity and mortality pattern of very low birth weight infants admitted in SNCU in a South Asian tertiary care centre

2018 ◽  
Vol 5 (3) ◽  
pp. 720 ◽  
Author(s):  
Kabilan S. ◽  
Mekalai Suresh Kumar
Keyword(s):  
Mechanical Ventilation ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Normal Vaginal Delivery ◽  
Vlbw Infants ◽  
The Mean

Background: Around 4-8% of all live births are very low birth weight (VLBW) infants.  In India currently 8 million VLBW infants are born each year which constitutes 40% of global burden the highest for any country. The present study was done to determine frequency of disease, complications, survival rate and risk factors for morbidity and mortality in VLBW babies.Methods: Between October 2016 and September 2017, we did a cross-sectional retrospective study at level three SNCU with >98% inborn admissions and about more than 10000 deliveries per year. The American Academy of Pediatrics protocol for neonatal resuscitation was followed for the management of VLBW. Data were entered in predetermined proforma and statistical analysis was done.Results: There were 154 registered cases of VLBW [75 females (48.7%) and 79 males (51.3%)]. The mean birth weight=1.198 (SD=0.211). The mean gestational age in weeks was 31.9 (SD=3.095).  Majority of them were in the gestational age 33-36 weeks (n=68, 44.2%), small for gestational age (n=89, 57.8), delivered through normal vaginal delivery (n=95, 61.7%), singletons (n=126, 81.8%), inborn (n=152, 98.7%), maternal age between 21-30 (n=95, 61.6%), clear amniotic fluid (n=137, 89%), on antenatal steroids (n=59, 38.3%), maternal disease were present in 55 mothers (33%) and gestational hypertension being more common (n=14, 9.6%). Majority of babies had Respiratory Distress Syndrome (n=56, 33.6%), birth asphyxia (n=54 32.4%) and sepsis (n=46, 27.6%). Mortality of 40.3% (n=62) observed in present study. Forty three babies with RDS, twenty babies with asphyxia and eight babies with sepsis expired.Conclusions: Multiple regression analysis with adjusted estimates of odds ratio showed that very low birth weight, low Apgar score at 5 minute, intubation and mechanical ventilation were predictors of outcome of VLBW babies. Birth weight and mechanical ventilation were significant predictors of the outcome of ELBW babies.

Intraventricular Hemorrhage in the Premature Neonate

2005 ◽  
Vol 24 (3) ◽  
pp. 55-71 ◽  
Author(s):  
Rebecca Owens
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infant ◽  
Gestational Age ◽  
Intraventricular Hemorrhage ◽  
Very Low Birth Weight ◽  
Premature Neonate ◽  
Vlbw Infants ◽  
Severe Hemorrhage ◽  
Common Variety

THE MOST COMMON VARIETY of neonatal intracranial hemorrhage is an intraventricular hemorrhage (IVH).1 Although much research has been conducted concerning the etiology and prevention of IVH in the preterm infant, the problem continues to plague very low birth weight (VLBW) infants (<1,500 grams) in particular. The risk of IVH correlates inversely with gestational age. The incidence of hemorrhage in the infant <28 weeks gestation is three times that of infants 28–31 weeks gestational age. The incidence of severe hemorrhage in infants <28 weeks gestational age is twice that of infants 28–31 weeks gestational age.2

scholarly journals Optimizing the growth of very-low-birth-weight infants requires targeting both nutritional and nonnutritional modifiable factors specific to stage of hospitalization

2019 ◽  
Vol 110 (6) ◽  
pp. 1384-1394 ◽  
Author(s):  
Michelle R Asbury ◽  
Sharon Unger ◽  
Alex Kiss ◽  
Dawn V Y Ng ◽  
Yunnie Luk ◽  
...  
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Positive Pressure ◽  
Time Interval ◽  
Vlbw Infants ◽  
Modifiable Factors ◽  
Baseline Characteristics

ABSTRACT Background Data on how baseline characteristics, acuity, morbidity, and nutrition work in combination to affect the growth of very-low-birth-weight (VLBW, &lt;1500 g) infants are limited. Objective We aimed to determine factors associated with in-hospital weight, length, and head circumference (HC) trajectories of VLBW infants. Methods VLBW infants (n = 316) from the GTA-DoMINO trial were included. Linear mixed-effects models assessed relations of baseline characteristics, acuity (at birth, across hospitalization), major morbidities, and nutrition (enteral feeding type, macronutrient/energy intakes) with changes in anthropometrics over hospitalization (days 1–8, 9–29, 30–75). Results Specific factors and the strength of their associations with growth depended on in-hospital time interval. Small-for-gestational-age infants experienced weight gain (4.3   g · kg−1 · d−1; 95% CI: 2.0, 6.5   g · kg−1 · d−1) during days 1–8, versus weight loss (−4.6     g · kg−1 · d−1; 95% CI: −5.6, −3.7     g · kg−1 · d−1) among appropriate-for-gestational-age infants (P &lt; 0.001). Positive-pressure ventilation (versus oxygen/room air) was associated with slower weight (−1.8    g · kg−1 · d−1) and HC (−0.25 cm/wk) gain during days 9–29 (P &lt; 0.001). Morbidities were negatively associated with growth after days 1–8, with patent ductus arteriosus (PDA) showing negative associations with weight (−2.7     g · kg−1 · d−1), length (−0.11 cm/wk), and HC (−0.21 cm/wk) gain during days 9–29 (P &lt; 0.001). Macronutrient/energy intakes were associated with weight across hospitalization (P ≤ 0.01), with greater weight gain (1.3–3.0 g  ·  kg−1  ·  d−1) among infants achieving macronutrient/energy recommendations during days 9–29 and 30–75. Macronutrient/energy intakes were associated with HC during the first month (P = 0.013–0.003), with greater HC gain (0.07–0.12 cm/wk) among infants achieving protein, lipid, and energy recommendations during days 9–29. Conclusions Baseline characteristics, acuity, morbidity, and nutrition factors were independently associated with VLBW infant growth. A focus on achieving macronutrient/energy recommendations and improving nutrient delivery to PDA-diagnosed infants may yield improvements to their growth. This trial was registered at www.isrctn.com as ISRCTN35317141.

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