Abstract
Background: Poor growth during the early years is well documented in children born prematurely but the relation between perinatal morbidity and subsequent growth retardation is poorly understood. Our aim was to determine, in children born appropriate for gestational age and with BW ≤1000 g, the main perinatal factors predictive of growth patterns at corrected age of 24 months
Methods: The growth outcome of 70 of the 87 ELBW AGA infants (GA 27.2±1.5 wks, BW 850±108 g) discharged from our NICU between 1998 and 2001 was assessed at 24 months of corrected age. Multiple regression analysis was used to assess several potential predictors of growth
Results: At birth the mean (SD) Z scores were −0.45±0.76 for W, −0.70±0.76 for L and −0.62±0.73 for HC. During hospitalization there was a significant fall in ZsW (−0.94 95%CI −1.24 to −0.63; p <0.0001) and ZsL (−0.85 95%CI −1.16 to −0.54; p <0.0001) but not in ZsHC (−0.24 95%CI −0.51 to 0.04; p =0.0944). At discharge (39,6±1,9 wks PMA) the prevalence of infants with Zs <-2 was 28.6% for W, 34.3% for L and 10.0% for HC. From discharge to 24 months of age, catch up growth was documented in 44.3% of infants for W, in 67.1% for L and in 35.7% for HC; during this period overall mean difference in Z scores was negative but not significant for W (−0.22 95%CI -0.59 to 0.16; p =0.2602), negative for HC (−0.42 95%CI -0.76 to −0.08; p =0.0157) and positive for L (0.42 95%CI 0.07 to 0.77; p =0.0186). At 24 months of age 37.1% of infants had Zs < -2 for W, 21.4% for L and 28.6 % for HC and the children were smaller on average in each of the three growth measures: Z scores were −1.61±1.22 for W, −1.17±1.16 for Height and −1.29±1.11 for HC. Multiple regression analysis identified days of oxygen therapy (coeff -0.008, p=0.032), NEC (coeff -1.40, p<0.032) and ZsW at discharge (coeff 0.64, p<0.0001) as the best predictors for ZsW at 24 months (r2 0.41). Days of oxygen therapy (coeff -0.011, p=0.010) and ZsL at discharge (coeff 0.28, p=0.040) were significant predictors for ZsL at 24 months (r2 0.33). ZsHC at discharge (coeff 0.65, p<0.0001) was the only predictor for ZsHC at 24 months (r2 0.44)
Conclusion: Poor growth during early postnatal period is common in ELBW infants and could predict the growth retardation at 2 years of age
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Maggio, L., Gallini, F., Cota, F. et al. 171 Perinatal Factors Influencing Later Growth Outcome In Elbw Infants. Pediatr Res 56, 493 (2004). https://doi.org/10.1203/00006450-200409000-00194
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DOI: https://doi.org/10.1203/00006450-200409000-00194