scholarly journals Individualized Postnatal Growth Trajectories for Preterm Infants

2018 ◽  
Vol 42 (6) ◽  
pp. 1084-1092 ◽  
Author(s):  
Erin Landau-Crangle ◽  
Niels Rochow ◽  
Tanis R. Fenton ◽  
Kai Liu ◽  
Anaam Ali ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Postnatal Growth ◽  
Growth Trajectories

scholarly journals Physiological adjustment to postnatal growth trajectories in healthy preterm infants

2016 ◽  
Vol 79 (6) ◽  
pp. 870-879 ◽  
Author(s):  
Niels Rochow ◽  
Preeya Raja ◽  
Kai Liu ◽  
Tanis Fenton ◽  
Erin Landau-Crangle ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Postnatal Growth ◽  
Growth Trajectories

scholarly journals Diagnostic Accuracy of Adjusted Growth Curves to Predict Cognitive Scores at 24 Months in Extremely Preterm Infants (P11-054-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Anisha Bhatia ◽  
Ariel Salas
Keyword(s):  
Multivariate Analysis ◽  
Diagnostic Accuracy ◽  
Preterm Infants ◽  
Growth Curves ◽  
Postnatal Growth ◽  
Growth Trajectories ◽  
Linear Regression Models ◽  
Growth Standards ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Abstract Objectives To compare the diagnostic accuracy of adjusted and unadjusted growth curves to define postnatal growth and predict neurodevelopment at age 2 years in extremely preterm infants. Methods We performed a retrospective cohort study assessing infant growth at 36 weeks post-menstrual age (PMA) in 350 extremely preterm infants born ≤ 26 6/7 weeks gestational age (GA) between 01/01/2006-12/31/2014 at University of Alabama at Birmingham Regional Neonatal Intensive Care Unit. Postnatal growth was defined as below, within, or above target using adjusted and unadjusted growth curves. Linear regression models were used to compare adjusted and standard growth trajectories at 36 weeks PMA. The primary outcome was Cognitive Composite Score (CCS) of the Bayley Scales of Infant Development-III (Bayley-III) at 24 months. Results Mean birthweight (BW) was 750 ± 138 g and median GA was 25 weeks (interquartile range: 24 to 26). A multivariate analysis of postnatal growth defined with adjusted curves and eight covariates (GA, BW, weight-Z-score at birth, sex, race, antenatal steroid use, singleton birth, and corrected age at follow-up assessment) predicted higher CCS-Bayley-III scores at 24 months in infants with postnatal growth within target (adjusted mean ± standard error: 89 ± 3) and lower scores in infants with postnatal growth below and above target (85 ± 3 vs. 83 ± 6, respectively) at 36 weeks PMA (P = 0.04). A multivariate analysis of postnatal growth defined with unadjusted curves and the same covariates did not predict significant differences in scores of infants with postnatal growth below (86 ± 3), within (86 ± 3), or above target (86 ± 6) at 36 weeks PMA (P = 0.99). Conclusions Adjusted growth curves identified an inverted “U-shaped” association between postnatal growth and CCS-Bayley-III scores at 24 onths. Individualized growth trajectories adjusted for physiologic weight loss may predict cognitive impairment more accurately than traditionally defined growth standards. Additional well-powered studies are needed to validate the diagnostic ability of adjusted growth curves in routine clinical practice. Funding Sources None.

Postnatal Growth Restriction in Preterm Infants: A Major Impact of Nutritional Practices and Methods of Assessment

2021 ◽  
Vol 03 ◽  
Author(s):  
Atef Alshafei ◽  
Mahmoud Galal ◽  
Anwar Khan ◽  
Yaser Saba ◽  
Moustafa Hassan
Keyword(s):  
Birth Weight ◽  
Preterm Infants ◽  
Growth Parameters ◽  
Caloric Intake ◽  
Growth Failure ◽  
Postnatal Growth ◽  
Protein Supplementation ◽  
Growth Restriction ◽  
Growth Trajectories ◽  
Z Score

Background: Nutritional management of preterm infants represents a significant challenge for most practitioners caring for sick and/or premature babies. Despite aggressive parenteral and enteral alimentation, a considerable number of preterm infants continue to fall far short of expected growth trajectories that match infants of similar gestation in-utero. Postnatal growth failure may be associated with future neurodevelopmental and cognitive impairments. Objective: The aim of the research is to investigate the incidence of postnatal growth restriction (PNGR) and characteristics of nutritional practices and growth parameters in a cohort of preterm infants born <32 weeks’ gestational age (GA) in a single neonatal intensive care unit (NICU). Methodology: This prospective study included 130 preterm infants born <32 weeks’ GA and admitted to the NICU between February 2018 and January 2020. The infants were divided into two groups: A (GA 23–26+6 weeks [n=50]) and B (27–31+6 weeks [n=80]). The association between PNGR and predicting risk factors was evaluated using logistic regression models. Results: PNGR was found in 62 (47%) infants at 28 days of life and increased to 73% of infants at 36 weeks’ postmenstrual age. Low birth weight and GA were independent factors predicting growth failure. PNGR was significantly correlated with birth weight (p < 0.01), length (p < 0.002), and GA (p < 0.03) at birth; however, HC was not a predictor of PNGR at 28 days. At 36 weeks’ PMA or discharge, PNGR was more pronounced in length, with a mean Z-score of -3.0, followed by weight, with a mean Z-score of -2.1, and an HC Z-score of -1.4. Conclusion : PNGR was significantly high in preterm infants <32 weeks’ gestation. A significant nutritional gap still exists between the recommended and actual caloric and protein supplementation, especially in the first few days after birth. Delayed optimization of caloric intake may be insufficient to promote growth trajectories, especially in preterm infants with significant morbidities.

scholarly journals Single-course antenatal corticosteroids is related to faster growth in very-low-birth-weight infant

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiajia Jing ◽  
Yiheng Dai ◽  
Yanqi Li ◽  
Ping Zhou ◽  
Xiaodong Li ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Very Low Birth Weight ◽  
Postnatal Growth ◽  
Weight Increase ◽  
Antenatal Corticosteroids ◽  
Lung Maturation ◽  
Growth Outcomes

Abstract Background Antenatal corticosteroids (ACS) treatment is critical to support survival and lung maturation in preterm infants, however, its effect on feeding and growth is unclear. Prior preterm delivery, it remains uncertain whether ACS treatment should be continued if possible (repeated course ACS), until a certain gestational age is reached. We hypothesized that the association of single-course ACS with feeding competence and postnatal growth outcomes might be different from that of repeated course ACS in very-low-birth-weight preterm infants. Methods A multicenter retrospective cohort study was conducted in very-low-birth-weight preterm infants born at 23–37 weeks’ gestation in South China from 2011 to 2014. Data on growth, nutritional and clinical outcomes were collected. Repeated course ACS was defined in this study as two or more courses ACS (more than single-course). Infants were stratified by gestational age (GA), including GA < 28 weeks, 28 weeks ≤ GA < 32 weeks and 32 weeks ≤ GA < 37 weeks. Multiple linear regression and multilevel model were applied to analyze the association of ACS with feeding and growth outcomes. Results A total of 841 infants were recruited. The results, just in very-low-birth-weight preterm infants born at 28–32 weeks’ gestation, showed both single and repeated course of ACS regimens had shorter intubated ventilation time compared to non-ACS regimen. Single-course ACS promoted the earlier application of amino acid and enteral nutrition, and higher rate of weight increase (15.71; 95%CI 5.54–25.88) than non-ACS after adjusting for potential confounding factors. No associations of repeated course ACS with feeding, mean weight and weight increase rate were observed. Conclusions Single-course ACS was positively related to feeding and growth outcomes in very-low-birth-weight preterm infants born at 28–32 weeks’ gestation. However, the similar phenomenon was not observed in the repeated course of ACS regimen.

scholarly journals Impact of size at birth and postnatal growth on metabolic and neurocognitive outcomes in prematurely born school-age children

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoo Jinie Kim ◽  
Seung Han Shin ◽  
Eun Sun Lee ◽  
Young Hwa Jung ◽  
Young Ah Lee ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Growth Velocity ◽  
Postnatal Growth ◽  
School Age ◽  
Z Score ◽  
Neurodevelopmental Outcomes ◽  
Neurocognitive Outcomes ◽  
Size At Birth

AbstractPrematurity, size at birth, and postnatal growth are important factors that determine cardiometabolic and neurodevelopmental outcomes later in life. In the present study, we aimed to investigate the associations between the size at birth and growth velocity after birth with cardiometabolic and neurodevelopmental outcomes in preterm infants. Fifty-six preterm infants born at < 32 weeks of gestation or having a birth weight of < 1500 g were enrolled and categorized into small for gestational age (SGA) and appropriate for gestational age (AGA) groups. Anthropometric and cardiometabolic parameters were assessed at school-age, and the Korean Wechsler Intelligence Scale for Children, fourth edition (K-WISC-IV) was used for assessing the intellectual abilities. The growth velocity was calculated by changes in the weight z-score at each time period. Multivariate analysis was conducted to investigate the associations of growth velocity at different periods with cardiometabolic and neurodevelopmental outcomes. Forty-two (75%) were classified as AGA and 25% as SGA. At school-age, despite the SGA children showing significantly lower body weight, lean mass index, and body mass index, there were no differences in the cardiometabolic parameters between SGA and AGA groups. After adjusting for gestational age, birth weight z-score, weight z-score change from birth to discharge and sex, change in weight z-score beyond 12 months were associated with a higher systolic blood pressure, waist circumference, and insulin resistance. Full-scale intelligent quotient (β = 0.314, p = 0.036) and perceptional reasoning index (β = 0.456, p = 0.003) of K-WISC-IV were positively correlated with postnatal weight gain in the neonatal intensive care unit. Although cardiometabolic outcomes were comparable in preterm SGA and AGA infants, the growth velocity at different time periods resulted in different cardiometabolic and neurocognitive outcomes. Thus, ensuring an optimal growth velocity at early neonatal period could promote good neurocognitive outcomes, while adequate growth after 1 year could prevent adverse cardiometabolic outcomes in preterm infants.

Aortic growth arrest after preterm birth: a lasting structural change of the vascular tree

2011 ◽  
Vol 2 (4) ◽  
pp. 218-225 ◽  
Author(s):  
U. Schubert ◽  
M. Müller ◽  
A.-K. Edstedt Bonamy ◽  
H. Abdul-Khaliq ◽  
M. Norman
Keyword(s):  
Preterm Birth ◽  
Carotid Artery ◽  
Preterm Infants ◽  
Growth Failure ◽  
Later Life ◽  
Postnatal Growth ◽  
Direct Result ◽  
Arterial Tree ◽  
Very Preterm Infants ◽  
Very Preterm

Young people who are born very preterm exhibit a narrower arterial tree as compared with people born at term. We hypothesized that such arterial narrowing occurs as a direct result of premature birth. The aim of this study was to compare aortic and carotid artery growth in infants born preterm and at term. Observational and longitudinal cohort study of 50 infants (21 born very preterm, all appropriate for gestational age, 29 controls born at term) was conducted. Diameters of the upper abdominal aorta and common carotid artery were measured with ultrasonography at three months before term, at term and three months after term-equivalent age. At the first assessment, the aortic end-diastolic diameter (aEDD) was slightly larger in very preterm infants as compared with fetal dimensions. Fetal aortic EDD increased by 2.6 mm during the third trimester, whereas very preterm infants exhibited 0.9 mm increase in aEDD during the same developmental period (P < 0.001 for group difference). During the following 3-month period, aortic growth continued unchanged (+0.9 mm) in very preterm infants, whereas postnatal growth in term controls slowed down to +1.3 mm (P < 0.001 v. fetal aortic growth). At the final examination, aEDD was 22% and carotid artery EDD was 14% narrower in infants born preterm compared with controls, also after adjusting for current weight (P < 0.01). Aortic and carotid artery growth is impaired after very preterm birth, resulting in arterial narrowing. Arterial growth failure may be a generalized vascular phenomenon after preterm birth, with implications for cardiovascular morbidity in later life.

scholarly journals Complementary Feeding Practices in a Cohort of Italian Late Preterm Infants

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1861 ◽  
Author(s):  
Maria Giannì ◽  
Elena Bezze ◽  
Lorenzo Colombo ◽  
Camilla Rossetti ◽  
Nicola Pesenti ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Complementary Feeding ◽  
Feeding Practices ◽  
Postnatal Growth ◽  
Late Preterm ◽  
Late Preterm Infants ◽  
Low Protein ◽  
Phone Calls ◽  
Nutritional Needs ◽  
Level I

Limited data are available on complementary feeding in preterm infants, who show increased nutritional needs and are at risk of altered postnatal growth. The aim of this study was to investigate the timing and content of complementary feeding in a cohort of late preterm infants. We conducted a prospective, observational study, including mothers who had given birth to infants admitted to level I or II of care with a gestational age between 34 and 36 weeks. Mothers were contacted at 3, 6 and 12 months after delivery by phone calls and were asked about their infant’s mode of feeding and the timing and schedule of the introduction of different solid foods types. A total of 49 mothers and 57 infants completed the study. The mean postnatal age of the introduction of complementary foods was 5.7 ± 0.7 months. Low energy and/or low protein-dense foods were first introduced in most infants. Fruit as the first type of complementary food in the infant’s diet was associated with a 1.6-month advance in initiating complementary feeding. The present findings provide further insight into complementary feeding practices in late preterm infants and underline the need for specific recommendations addressing this vulnerable population.

scholarly journals Early Postnatal Growth in Preterm Infants and Cord Blood Leptin

2004 ◽  
Vol 24 (12) ◽  
pp. 751-756 ◽  
Author(s):  
Vania Matos Fonseca ◽  
Rosely Sichieri ◽  
Maria Elizabeth Lopes Moreira ◽  
Aníbal Sanchez Moura
Keyword(s):  
Cord Blood ◽  
Preterm Infants ◽  
Postnatal Growth
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