Extrauterine growth retardation in premature infants in Shanghai: a multicenter retrospective review

Shan, Hong Mei; Cai, Wei; Cao, Yun; Fang, Bing; Feng, Yi

doi:10.1007/s00431-008-0885-9

Cited by 57 publications

(39 citation statements)

References 15 publications

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“…In other words, the chance of reaching a normal weight decreases as the time to achieve a normal growth rate increases 2,41,42,[45][46][47] . On the other hand, Shan et al 32 associated EUGR with an increase in gestational age, which agrees with our results.…”

Section: Discussionsupporting

confidence: 93%

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Extrauterine growth restriction: Universal problem among premature infants

et al. 2016

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Objective: To analyze the growth rate of premature infants in the first weeks of life and factors associated with extrauterine growth restriction. Methods: This is a cross-sectional study of 254 premature infants in a neonatal intensive care unit conducted from January 1, 2008 to December 31, 2010. Infants who died or had malformations incompatible with life were excluded. Median weight curves according to gestational age were constructed for the first four weeks of life. The Fenton growth chart calculations provided the weight Z-scores. Extrauterine growth restriction was defined as corrected weight-for-age Z-score ≤-2. Perinatal, morbidity, and health care variables were analyzed. The Poisson regression model yielded the prevalenceratios . Associations between extrauterine growth restriction and the perinatal, morbidity, and care variables were investigated. Poisson regression controlled possible confounding factors. Results: The frequency of extrauterine growth restriction was 24.0%. Most (85.0%) small-for-gestational-age infants developed extrauterine growth restriction; 55.3% of extrauterine growth restriction cases involved small-for-gestational-age infants. Premature infants with gestational age >32 weeks did not recover the median birth weight until the third week of life and had a higher frequency of small-for-gestational-age. The Z-scores of non-small-for-gestational-age infants decreased more after birth than those of small-for-gestational-age infants. extrauterine growth restriction was associated with small-for-gestational-age (PR=6.14; 95%CI=3.33-11.33;p <0.001) and time without enteral diet (PR=1.08; 95%CI=1.04-1.13; p =0.010). Conclusion: Extrauterine growth restriction occurs in premature infants of all gestational age. The participation of small-for-gestational-age and nutritional practices in its genesis is noteworthy. We suggest prospective studies of all premature infants. The implementation of best care practices, individualized for small-for-gestational-age infants, to improve nutrient supply can minimize the problem.

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Section: Discussionsupporting

confidence: 93%

“…Gianini et al 28 also associated small for gestational age at birth with EUGR. Other studies have also found this association, but the EUGR rates varied from 16.0 to 63.0% [29][30][31][32] . Shan et al 32 found EUGR in 44.0% to 62.2% of premature infants.…”

Section: Discussionmentioning

confidence: 67%

Extrauterine growth restriction: Universal problem among premature infants

et al. 2016

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“…6,14,44,45 In our population, the frequency of newborns with weight below the 10 th percentile for age increased from 30.4% at birth to 76.1% at post-conceptual age of term, and the associated factors were SGA, sepsis and higher time for attaining exclusive enteral nutrition. The association between restriction of extra-uterine growth, SGA, bronchopulmonary dysplasia, number of days of parenteral nutrition and age to attain exclusive enteral nutrition has also been shown in other studies.…”

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confidence: 78%

Nutritional practices and postnatal growth restriction in preterm newborns

Lima

Goulart

Bortoluzzo

et al. 2015

Rev. Assoc. Med. Bras.

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Objective: to assess the nutritional practices in neonatal intensive care units (NICU) associated with growth retardation in premature (preterm) infants. Methods: retrospective study of preterm infants weighing between 500 and 1,499g admitted to NICU. Evolution of growth and parenteral (PN) and enteral (EN) nutrition practices were analyzed. Results: among 184 preterm infants divided into G1 (500 to 990g; n=63) and G2 (1000 to 1499g; n=121), 169 received PN (G1=63, G2=106). Compared with the recommendations, PN was started late, its progress was slow and the maximum glucose, amino acid, lipid and energy supplies were low in both groups. The initial supply of amino acid and lipid and initial and maximum glucose and energy were lower in G1. The onset of EN was early (1-2 days), the time to reach exclusive EN was appropriate (11-15 days) and the use of human milk was possible in a reasonable amount of time (7-13 days). The multivariate analysis showed that respiratory distress syndrome and obtaining a supply of 120 kcal/kg/day too late increased the chance of weight loss greater than 10%. Sepsis, maximum energy supply for PN <60 kcal/kg/day and obtaining a supply of 120 kcal/kg/ day too late increased the chance of regaining birth weight after 14 days, while small for gestational age (SGA) at birth reduced this chance. SGA at birth, sepsis and achieving exclusive enteral nutrition after 14 days increased the chance of being SGA at post-conceptual age of term. Conclusion: improving nutritional practices in the NICU can reduce the growth deficit in premature infants of very low birth weight.

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“…In Senegal, Faye et al [32] reported extra-uterine growth retardation (86%), underweight (61%), and underweight at 40 weeks post-conception (41%), at 3 months and at 6 months of gestation-adjusted age. Other higher rates of underweight were reported in Morocco (77.5%) [33], Tunisia (55%) [34], China (56.8%) [35] and Japan (49%) [36].…”

Section: Discussionmentioning

confidence: 95%