Extrauterine growth restriction was associated with short stature and thinness in very low birthweight infants at around six years of age

Takayanagi, Tetsuya; Shichijo, Akinori; Egashira, Masayuki; Egashira, Tomoko; Mizukami, Tomoko

doi:10.1111/apa.14433

Cited by 16 publications

(15 citation statements)

References 16 publications

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“…However, to draw comparisons between different centers is di cult not only because de nition of EUGR and reference growth charts differ, but also because maternal and clinical characteristics of the study population, time at EUGR evaluation (36 weeks, 40 weeks PMA, discharge) and choice of ΔSDS threshold when applying the longitudinal-EUGR de nition (> 1, >2 SDS), changes. EUGR rates from NICUs of high-income countries similar to ours, evaluated at discharge, varied from 17% to 77.2% for the cross-sectional EUGR [4,[25][26][27][28][29], from 29.8-39.1% for longitudinal-1 de nition [30,31] and from 5.2-13% for longitudinal-2 EUGR [30][31][32].…”

Section: Discussionmentioning

confidence: 63%

Extrauterine growth restriction in very low birth weight infants according to different growth charts: a retrospective 10 years observational study

Starc

Giangreco

Centomo

et al. 2022

Preprint

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Background Extrauterine growth restriction (EUGR) is common among very low birth weight (VLBW) infants and associated with poor neurodevelopmental outcomes. Prevalence of EUGR is a basic indicator of ‘nutritional care’ and an important health outcome measure. There are two types of EUGR definitions (cross-sectional and longitudinal) and many growth charts for monitoring postnatal growth. Aims of our study were 1) to compare the rate of small for gestational rate (SGA) and EUGR in a population of VLBW infants, both according to different growth charts (Fenton, INeS charts and Intergrowth-21) and according to different definitions; 2) to identify risk factors for EUGR. Methods this is a single centre retrospective observational study, including all VLBW infants born between 1st of January 2009 and 31st of December 2018. Anthropometric measures were obtained at birth and at discharge and presented as z-scores according to three growth charts (Fenton, INeS charts, Intergrowth-21). Maternal, clinical and nutritional data were retrieved from clinical records. Results 228 VLBW were included. Percentage of SGA did not change significantly according to the three different growth charts (Fenton 22.4%, INeS charts 22.8%, Intergrowth 28.2%, p 0.27). Prevalence of EUGR was significatively higher when INeS and Fenton charts were used, compared to Intergrowth charts regardless of EUGR-definition (cross sectional-EUGR: Fenton 33.5%, INeS charts 40.9%, Intergrowth-21 23.8%, p 0.001; longitudinal-EUGR (loss of 1SDS): Fenton 15%, INeS charts 20.4%, Intergrowth 4%, p < 0.001). In our population late-onset-sepsis increased the risk of longitudinal EUGR (OR: 2.69, 95%CI: 0.79–9.17), similarly as a longer time to reach 100 ml/kg of feeds (OR: 1.12, 95%CI: 0.97–1.29). On the contrary, preeclampsia was a protective factor for longitudinal EUGR. Conclusions We confirmed a wide variability of EUGR rates when using different charts and definitions, highlighting that Intergrowth-21 charts identify less EUGR when compared to INeS and Fenton charts. Standardized criteria for defining EUGR are warranted in order to facilitate comparisons between studies and to improve the nutritional management of VLBW infants.

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Section: Discussionmentioning

confidence: 63%

Extrauterine growth restriction in very low birth weight infants according to different growth charts: a retrospective 10 years observational study

Starc

Giangreco

Centomo

et al. 2022

Preprint

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“…Furthermore, preterm infants usually suffer from nutrients (e.g., vitamin A, D, iron) insufficiency [2, 3]. Ultimately birth weight, a decrease in z-score for body weight or length is considered a predictor of growth retardation; at the same time, very low birth weight might be a risk factor for the subsequent occurrence of growth hormone deficiency [15,30]. Therefore, we should thoroughly consider all issues mentioned above when conducting nutritional risk screening for preterm infants.…”

Section: Nrsp Subscale 1 Was Preterm-infant-specificmentioning

confidence: 99%

“…Nutrients required for catch-up growth are sufficient energy, protein, vitamins, and minerals [13, 14]. Studies also found that extrauterine growth retardation and decrease in z -score of body weight or length were significant predictors of growth failure in early childhood [15]. Consequently, when developing a nutritional risk screening tool specific for preterm infants, the issues mentioned above should be under consideration.…”

Section: Introductionmentioning

confidence: 99%

The Development and Evaluation of the Nutritional Risk Screening Tool for Preterm Infants from Birth to Corrected Age Four Months Old: A Pilot Study

Jiang

Nasr

et al. 2022

Ann Nutr Metab

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Introduction: Premature infants are exceptionally vulnerable to nutrition-related diseases, and the utilization of standardized feeding guidelines may reduce nutritional practice variation, which can promote growth. Nutritional risk screening is the first step for standardized nutrition advice. However, risk screening tools specific for following up preterm infants are scarce. Hence, our study aimed to develop and evaluate a standardized Nutritional Risk Screening Tool for Preterm Infants (NRSP subscale 1) from birth to corrected age four months old . Methods: This study was a two-phase (the development phase and evaluation phase) study. Initially, we used the Delphi expert consultation method to create NRSP subscale 1. Then, a professional panel interviewed the participated preterm infants using the screening tool, measured anthropometric parameters, and conducted an intellectual development test on the interview day and remeasured anthropometric parameters 2 weeks or 1 month after the first interview. In the development phase, we cross-tabulated the responses to the screening tool with the classifications of z-scores of the body weight, length, or head circumference to identify significant predictors of underweight, stunting, or microcephaly. We then combined significant predictors to produce models for predicting underweight, stunting, or microcephaly by multivariate logistic regression analysis. In the evaluation phase, the area under the curve (AUC), sensitivity, specificity, and correlation coefficient by Spearman’s correlation analysis (rs) between the risk classifications by NRSP subscale 1 and the classifications of the z-scores of the body weight, length, or head circumference were calculated to assess the validity of the screening tool. Intellectual development levels between high and low nutritional risk infants were statistically compared. Results: A total of 219 and 244 preterm infants were included to two phases, respectively. AUC was 0.936 (95% CI: 0.860–1.000, p < 0.001), sensitivity was 0.667, specificity was 0.941, rs = 0.407 (p < 0.001); AUC was 0.794 (95% CI: 0.638–0.951, p = 0.002), sensitivity was 0.500, specificity was 0.953, rs = 0.339 (p < 0.001); AUC was 0.831 (95% CI: 0.737–0.925, p = 0.001), sensitivity was 0.889, specificity was 0.643, rs = 0.215 (p = 0.001) in predicting underweight, stunting, and microcephaly on the interview day, respectively. AUC was 0.905 (95% CI: 0.826–0.984, p = 0.006), sensitivity was 0.500, specificity was 0.905, rs = 0.504 (p < 0.001); AUC was 0.738 (95% CI: 0.515–0.960, p = 0.034), sensitivity was 0.429, specificity was 0.848, rs = 0.382 (p < 0.001); AUC was 0.664 (95% CI: 0.472–0.856, p = 0.071), sensitivity was 0.455, specificity was 0.809, rs = 0.169 (p = 0.037) in predicting underweight, stunting, and microcephaly 2 weeks or 1 month after the first interview, respectively. Gross motor development quotients (DQs) (95.85 [32.87] vs. 86.29 [17.19], p = 0.022), fine motor DQs (115.77 [46.03] vs. 102.12 [20.27], p = 0.010), and verbal DQs (110.73 [35.27] vs. 100.63 [21.28], p = 0.042) were higher in low nutritional risk infants than high-risk ones. Conclusion: NRSP subscale 1 was acceptable and reliable in predicting underweight, but the validity in predicting stunting or microcephaly was slightly mild. Further investigations are required to authenticate NRSP subscale 1’s effectiveness.

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“…Extrauterine growth restriction (EUGR), defined as an anthropometric measure that is lower than the 10th percentile, is prevalent and occurs in the majority of very preterm infants [ 1 ]. Preterm infants with EUGR at discharge have been shown to develop short stature, poor neurodevelopmental outcomes, and cardiovascular and metabolic problems after they grow up [ 2 , 3 , 4 , 5 , 6 ]. EUGR has been linked to intrauterine growth restriction, maternal preeclampsia, low gestational age (GA), feeding intolerance, delay in first enteral feeding, and inadequate nutritional supplement [ 1 , 7 , 8 , 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Growth of Very Preterm Infants in a Low-Resourced Rural Setting after Affiliation with a Human Milk Bank

et al. 2022

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The extrauterine growth restriction (EUGR) of very preterm infants has been associated with long-term complications and neurodevelopmental problems. EUGR has been reported at higher rates in low resource settings. There is limited research investigating how metropolitan human milk banks contribute to the growth outcomes of very preterm infants cared in rural areas. The setting of this study is located at a rural county in Taiwan and affiliated with the Taiwan Southern Human Milk Bank. Donor human milk was provided through a novel supplemental system. A renewal nutritional protocol was initiated as a quality improvement project after the affiliated program. This study aimed to compare the clinical morbidities and growth outcome at term equivalent age (TEA) of preterm infants less than 33 weeks of gestational age before (Epoch-I, July 2015–June 2018, n = 40) and after the new implementation (Epoch-II, July 2018–December 2020, n = 42). The Epoch-II group significantly increased in bodyweight z-score at TEA ((−0.02 ± 1.00) versus Epoch-I group (−0.84 ± 1.08), p = 0.002). In multivariate regression models, the statistical difference between two epochs in bodyweight z-score changes from birth to TEA was still noted. Modern human milk banks may facilitate the nutritional protocol renewal in rural areas and improve the growth outcomes of very preterm infants cared for. Establishing more distribution sites of milk banks should be encouraged.

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Extrauterine growth restriction was associated with short stature and thinness in very low birthweight infants at around six years of age

Abstract: Extrauterine growth restriction was significantly associated with short stature and thinness in VLBW infants at around six years, irrespective of the degree of SGA.

Cited by 16 publications

References 16 publications

Extrauterine growth restriction in very low birth weight infants according to different growth charts: a retrospective 10 years observational study

Extrauterine growth restriction in very low birth weight infants according to different growth charts: a retrospective 10 years observational study

The Development and Evaluation of the Nutritional Risk Screening Tool for Preterm Infants from Birth to Corrected Age Four Months Old: A Pilot Study

Growth of Very Preterm Infants in a Low-Resourced Rural Setting after Affiliation with a Human Milk Bank

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