Very preterm infants admitted to a tertiary neonatal unit in central Vietnam showed poor postnatal growth

Abstract

Premature birth and its complications are major challenges for global healthcare. An estimated 5.3 million children under five years of age died in 2018, and complications from preterm birth accounted for 18% of these deaths. 1 There are an estimated 15 million babies born prematurely each year, comprising 11% of all births (range 5%-18%). 2 In 65 countries with reliable data, there has been an increase in premature births over the past two decades.Preterm infants have a higher mortality rate than term infants, not just in the neonatal period, but also during the first year of life. This ratio is inversely proportional to gestational age and birth weight. Although survival rates have improved considerably in recent years, these infants remain vulnerable because of the complications of prematurity, such as bronchopulmonary dysplasia, hearing and vision problems and poor growth and neurodevelopmental compromise. The high incidence of neural injury highlights the need for postnatal strategies and interventions to support maturation of their neural system and therefore their neurodevelopment.Providing adequate nutrition for growth and development is fundamental for the care of premature infants. Early postpartum nutrition has a significant impact on outcomes, including growth, body

Poor postnatal growth in preterm infants

“…Recently, Rochow et al 3 showed that z‐score alone may not be a good indicator of postnatal growth and suggested using weight gain ratio. The other reassuring observation noted in the study of Tran et al 1 was a low incidence of small for gestational age infants in their cohort (3.8%, 3/78). The US SGA births in 2009 and 2010 were reported to be around 10% 4 …”

“…In conclusion, the study by Tran et al 1 is impressive, but I think looking at the average GV of the cohort, we should not label the infants to have poor growth just based on z‐score alone.…”

“…I read with interest the article by Tran et al 1 describing the high rate of poor growth among very preterm infants. While looking at the data, it was interesting to note that the median growth velocity (GV) or rate of weight gain for all groups ranged from 11.4 to 13.3 g/kg/day (Table ), which is higher than the average GV reported by Patel et al 2 They reported the mean GV of 9.82 g/kg/day by exponential model and mean GV of 9.6 g/kg/day by the point average weight model.…”

Risk Factors for Mortality or Major Morbidities of Very Preterm Infants: A Study from Thailand

“…The numbers (percentages) of males and the histories of antenatal steroid administration were: 317 neonates (57.1%) and 423 neonates (76.2%), respectively. The median (IQR) GA and BW were 29 (27)(28)(29)(30)(31) weeks and 1180 (860-1475) grams, respectively. The lowest GA and BW were 22 weeks and 410 grams, respectively.…”

Adding the weight gain ratio to our study did not provide added benefits when identifying poor growth in very preterm infants

“…We thank Dr Manzar for his interest in our publication 1 and his interesting comments 2 . He suggested that defining poor growth in very preterm infants should not be based on z ‐scores alone.…”