Longitudinal Growth of Hospitalized Very Low Birth Weight Infants

Abstract

These growth curves may be used to better understand postnatal growth, to help identify infants developing illnesses affecting growth, and to aid in the design of future research. They should not be taken as optimal. Randomized clinical trials should be performed to evaluate whether different nutritional management practices will permit birth weight to be regained earlier and result in more rapid growth, more appropriate body composition, and improved short- and long-term outcomes.

Improved growth and decreased morbidities in <1000 g neonates after early management changes

“…The enhanced growth velocity in the post-EMPC group likely relates to the early anabolic state achieved with use of early amino acids. 17,27,28,30 In addition, the decreased energy required for healing from barotrauma, volutrauma and oxidant injury with use of CPAP and decreased oxygen saturation ranges is likely contributing to the enhanced growth.…”

“…[12][13][14] Early amino-acid supplementation dramatically improves the nitrogen balance of ELBW infants, shifting these patients from the catabolic state traditional parenteral support induces to a healthier anabolic state. [15][16][17] The ultimate goal of these three interventions is to improve short-and long-term outcomes. Our primary outcome measure was growth, as EUGR is associated with significantly lower Bayley Mental Development Index (MDI) and Psychomotor Index (PDI) scores at 2 years of age, 18 and impaired long-term growth potential.…”

Post-Discharge Nutrition of Preterm Infants

“…7,8 All groups initially lost weight and birth weight was regained by approximately 2.5 weeks; however, by 32 weeks postmenstrual age, the growth curves of all three groups were below the 10th percentile for in utero growth. The weight differences represented 35 to 41% of the average weight of a 32-week fetus.…”

Pragmatic Approach to In-Hospital Nutrition in High-Risk Neonates

“…1 These ELBW infants do not regain birth weight until 2-3 weeks of age. The growth of most ELBW infants proceeds at a slower rate than in utero, often by a large margin.…”

“…For each gestational age category, the postnatal study growth curve was shifted to the right of the reference curve. 1 Therefore, this ''growth deficiency'' is common in ELBW infants. Nutrient intakes received by ELBW infants are lower than the uptakes by the fetus, and this intake deficit persists throughout much of the infants' stay in the hospital and beyond.…”