scholarly journals Association of First-Week Nutrient Intake and Extrauterine Growth Restriction in Moderately Preterm Infants: A Regional Population-Based Study

Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 227
Author(s):  
Marine Baillat ◽  
Vanessa Pauly ◽  
Gina Dagau ◽  
Julie Berbis ◽  
Farid Boubred ◽  
...  
Keyword(s):  
Gestational Age ◽  
Neonatal Morbidity ◽  
Population Based ◽  
Growth Restriction ◽  
Z Score ◽  
Weight Growth ◽  
Lower Total Energy ◽  
Nutrition Intake ◽  
Neonatal Growth ◽  
Extrauterine Growth Restriction

The purpose of this study was to determine the influence of first-week nutrition intake on neonatal growth in moderate preterm (MP) infants. Data on neonatal morbidity and nutrition intake on day of life 7 (DoL7) were prospectively collected from 735 MP infants (320/7–346/7 weeks gestational age (GA)). Multivariable regression was used to assess the factors associated with extrauterine growth restriction (EUGR) defined as a decrease of more than 1 standard deviation (SD) in the weight z-score during hospitalization. Mean (SD) gestational age and birth weight were 33.2 (0.8) weeks and 2005 (369) g. The mean change in the weight z-score during hospitalization was −0.64 SD. A total of 138 infants (18.8%) had EUGR. Compared to adequate growth infants, EUGR infants received 15% and 35% lower total energy and protein intake respectively (p < 0.001) at DoL7. At DoL7, each increase of 10 kcal/kg/d and 1 g/kg/d of protein was associated with reduced odds of EUGR with an odds ratio of 0.73 (95% CI, 0.66–0.82; p < 0.001) and 0.54 (0.44–0.67; p < 0.001), respectively. Insufficient energy and protein intakes on DoL7 negatively affected neonatal growth of MP infants. Nutritional support should be optimized from birth onwards to improve neonatal weight growth.

scholarly journals Neuropsychological Development and New Criteria for Extrauterine Growth Restriction in Very Low-Birth-Weight Children

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 955
Author(s):  
Leticia Alcántara ◽  
Cristina Fernández-Baizán ◽  
Lara González-García ◽  
Enrique García-López ◽  
Clara González-López ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neuropsychological Tests ◽  
Very Low Birth Weight ◽  
Growth Parameters ◽  
Growth Restriction ◽  
Z Score ◽  
Neuropsychological Development ◽  
Neonatal Growth ◽  
Extrauterine Growth Restriction

Background: Controversy between short-term neonatal growth of very low birth-weight preterm (VLBW) and neurodevelopment may be affected by criteria changes of extrauterine growth restriction (EUGR). Objective: to determine if new EUGR criteria imply modifications in the relationship between old criteria and results of neuropsychological tests in preterm children. Patients and methods: 87 VLBW at 5–7 years of age were studied. Neuropsychological assessment included RIST test (Reynolds Intellectual Sctreening Test) and NEPSY-II (NE neuro, PSY psycolgy assessment) tests. The relationships between these tests and the different growth parameters were analyzed. Results: RIST index was correlated with z-score Fenton’s weight (p = 0.004) and length (p = 0.003) and with z-score IGW-21’s (INTERGRWTH-21 Project) weight (p = 0.004) and length (p = 0.003) at neonatal discharge, but not with z-score difference between birth and neonatal discharge in weight, length, and HC for both. We did not find a statistically significant correlation between Fenton or IGW-21 z-scores and scalar data of NEPSY-II subtasks. Conclusion: In our series, neonatal growth influence on neuropsychological tests at the beginning of primary school does not seem robust, except for RIST test. New EUGR criteria do not improve the predictive ability of the old ones.

scholarly journals Intrauterine Growth Restriction: Antenatal and Postnatal Aspects

2016 ◽  
Vol 10 ◽  
pp. CMPed.S40070 ◽  
Author(s):  
Deepak Sharma ◽  
Sweta Shastri ◽  
Pradeep Sharma
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Perinatal Asphyxia ◽  
Neonatal Morbidity ◽  
Growth Restriction ◽  
Growth Potential ◽  
Intrauterine Growth ◽  
Health And Disease ◽  
Neonatal Problems

Intrauterine growth restriction (IUGR), a condition that occurs due to various reasons, is an important cause of fetal and neonatal morbidity and mortality. It has been defined as a rate of fetal growth that is less than normal in light of the growth potential of that specific infant. Usually, IUGR and small for gestational age (SGA) are used interchangeably in literature, even though there exist minute differences between them. SGA has been defined as having birth weight less than two standard deviations below the mean or less than the 10th percentile of a population-specific birth weight for specific gestational age. These infants have many acute neonatal problems that include perinatal asphyxia, hypothermia, hypoglycemia, and polycythemia. The likely long-term complications that are prone to develop when IUGR infants grow up includes growth retardation, major and subtle neurodevelopmental handicaps, and developmental origin of health and disease. In this review, we have covered various antenatal and postnatal aspects of IUGR.

Intrauterine growth restriction affects z-scores of anthropometric parameters during the first 6 years in very low-birth-weight-children born at less than 30 weeks of gestation

2019 ◽  
Vol 11 (1) ◽  
pp. 44-48
Author(s):  
Hiromichi Shoji ◽  
Akiko Watanabe ◽  
Atsuko Awaji ◽  
Naho Ikeda ◽  
Mariko Hosozawa ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Very Low Birth Weight ◽  
Growth Restriction ◽  
Z Score ◽  
Anthropometric Parameters ◽  
Intrauterine Growth ◽  
Z Scores

AbstractObjective:Little is known about physical constitution outcomes for very preterm infants. Here, we compare z-scores of anthropometric parameters up to 6 years of age in children born with very low birth weight (VLBW) at less than 30 weeks of gestation, with or without intrauterine growth restriction (IUGR).Design:Participants were divided into four subgroups: male (M), small for gestational age (SGA) (n = 30); M, appropriate for gestational age (AGA) (n = 59); female (F), SGA (n = 24); and F, AGA (n = 61). z-Scores of body weight (BW), body length (BL), and body mass index (BMI) were assessed at birth, 1 year corrected age, 3 years of age, and 6 years of age.Results:For boys, BW and BMI were significantly lower among SGA children than among AGA children at all assessments, but there was no difference in BL at 3 or 6 years. For girls, BW and BL were significantly lower among SGA children than among AGA children at all assessments, but no difference was detected in BMI after 1.5 years. No significant variation in the z-score of BW or BMI in either SGA group was observed after 1 year. BL z-score in all groups gradually increased until 6 years of age.Conclusion:IUGR affects BW and BMI in boys and BW and BL in girls during the first 6 years in VLBW children born at less than 30 weeks of gestation. SGA children did not catch up in BW or BMI from 1 to 6 years of age.

scholarly journals Consecutive measurements show association of IGF-1 with fetal growth in type 1 diabetic pregnancy

2021 ◽  
Vol 9 (6) ◽  
Author(s):  
Greta Dubietyte ◽  
Karsten Kaiser ◽  
Michael Nielsen ◽  
Finn Lauszus
Keyword(s):  
Blood Pressure ◽  
Type 1 Diabetes ◽  
Fetal Growth ◽  
Gestational Age ◽  
Growth Restriction ◽  
The Other ◽  
Z Score ◽  
Different Levels ◽  
In Pregnancy

Background: Abnormal fetal growth can lead to adverse outcomes in pregnancy as well in later postnatal life and is more prevalent in diabetic pregnancies. These are usually associated with large for gestational age neonates, an issue that has already been broadly examined. On the other side, diabetes in pregnancy can also relate to intrauterine growth restriction and small for gestational age neonates. During pregnancy, maternal IGF-1 is secreted excessively and additionally produced by placenta, which regulates transport of nutrients to the fetus acting through an IGF-receptor and accordingly affects its growth. As type 1 diabetes carries a higher risk of adverse events associated with fetal growth there is a natural focus on possible links between IGF-1 and fetal growth. Aim: The present study investigated the time-course relationship between the maternal serum IGF-1 and the birthweight as an obstetrical outcome in type 1 diabetic pregnancies with various levels of background risk. Methods: 130 pregnant women with type 1 diabetes were consecutively recruited for measurement of growth factors, genes affecting coagulation, evaluated for diabetes status, and perinatal outcome. The birthweight z-score was computed and grouped into tertiles for analysis of association with repeated measurements of IGF-1. Diurnal blood pressure was measured by monitor. Retinopathy grade was evaluated by two specialists independently, blinded of the clinical data. Blood samples for IGF-1 during pregnancy were drawn from week 6 and every 4th week until week 30, then every 2 nd week. Genomic DNA was extracted from peripheral blood. Results: The median of the lowest tertile of birthweight z-score was 0.4 (-1 - +1.3) and included more women with micro/macroalbuminuria than the middle and upper tertile; however, ¾ had normoalbuminuria and no further sign of surplus vasculopathy compared to the other tertile groups. The lowest birthweights were associated with a lower rise in IGF-1 from week 22 to 32. Neither glycemic control, genetics, grade of retinopathy, renal function nor vascular resistance indices in diurnal blood pressure were different between the tertile groups. Conclusion: Our main finding is that lower IGF-1 levels are associated with subsequent lower birthweight in diabetic pregnancy and is displayed markedly at the end of 2nd trimester. We hypothesize that the relative low birthweight, despite being within the limits of appropriate for gestational age may display inappropriate growth if not outright growth-restriction. We were able to discern different levels of growth at a critical point in pregnancy where ultrasound may pick up different levels of growth patterns and optimized care can be commenced.

scholarly journals Incidence and associated factors of extrauterine growth restriction (EUGR) in preterm infants, a cross-sectional study in selected NICUs in Ethiopia

2020 ◽  
Vol 4 (1) ◽  
pp. e000765
Author(s):  
Netsanet Workneh Gidi ◽  
Robert L Goldenberg ◽  
Assaye K Nigussie ◽  
Elizabeth McClure ◽  
Amha Mekasha ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Low Income ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Growth Restriction ◽  
Sectional Study ◽  
Cross Sectional ◽  
Increased Risk ◽  
Extrauterine Growth Restriction

BackgroundPreterm infants have high risk of developing growth restriction and long-term complications. Enteral feeding is often delayed in neonatal intensive care units (NICUs) for the fear of feeding intolerance and the associated necrotising enterocolitis, and recent advances in nutritional support are unavailable in low-income countries.ObjectiveThe aim of this study was to assess the incidence and associated factors of extrauterine growth restriction (EUGR) among preterm infants in selected NICUs in Ethiopia.MethodThis was a cross-sectional study involving a subgroup analysis of preterm infants admitted to hospitals, from a multicentre descriptive study of cause of illness and death in preterm infants in Ethiopia, conducted from 2016 to 2018. EUGR was defined as weight at discharge Z-scores <−1.29 for corrected age. Clinical profiles of the infants were analysed for associated factors. SPSS V.23 software was used for analysis with a significance level of 5% and 95% CI.ResultFrom 436 preterm infants included in the analysis, 223 (51%) were male, 224 (51.4%) very low birth weight (VLBW) and 185 (42.4%) small for gestational age (SGA). The mean (SD) of weight for corrected age Z-score at the time of discharge was −2.5 (1.1). The incidence of EUGR was 86.2%. Infants who were SGA, VLBW and longer hospital stay over 21 days had increased risk of growth restriction (p-value<0.01). SGA infants had a 15-fold higher risk of developing EUGR at the time of discharge from hospital than those who were appropriate or large for gestational age (OR (95% CI)=15.2 (4.6 to 50.1).ConclusionThe majority of the infants had EUGR at the time of discharge from the hospital, which indicates suboptimal nutrition. Revision of national guidelines for preterm infants feeding and improvement in clinical practice is highly required.

scholarly journals Extrauterine growth restriction: Universal problem among premature infants

2016 ◽  
Vol 29 (1) ◽  
pp. 53-64 ◽  
Author(s):  
Brunnella Alcantara Chagas de FREITAS ◽  
Silvia Eloiza PRIORE ◽  
Luciana Moreira LIMA ◽  
Sylvia do Carmo Castro FRANCESCHINI
Keyword(s):  
Premature Infants ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Poisson Regression ◽  
Growth Restriction ◽  
Growth Chart ◽  
Perinatal Morbidity ◽  
Cross Sectional ◽  
Z Scores ◽  
Extrauterine Growth Restriction

ABSTRACT 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.

scholarly journals Vertically transmitted infections and extrauterine growth restriction in preterm neonates: a new risk factor

2021 ◽  
Vol 21 (1) ◽  
pp. 107-115
Author(s):  
Verônica Cheles Vieira ◽  
Raquel Cristina Gomes Lima ◽  
Daiane Borges Queiroz ◽  
Danielle Souto de Medeiros
Keyword(s):  
Premature Infants ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Positive Association ◽  
Final Analysis ◽  
Growth Restriction ◽  
Preterm Neonates ◽  
Clinical Practices ◽  
Increased Risk ◽  
Extrauterine Growth Restriction

Abstract Objectives: to investigate the association between Vertically Transmitted Infections (VTI) and Extrauterine Growth Restriction (EUGR) among premature infants in Neonatal Intensive Care Units (NICU). Methods: part of a large non-concurrent cohort study with medical records analysis. We evaluated EUGR in premature infants at a gestational age at birth of > 32 weeks and <36 weeks and presented a corrected gestational age of 36 completed weeks during a 27-day birth follow-up. Premature infants with major congenital anomalies were excluded. We analyzed associations among EUGR, VTI and covariables related to maternal disease, birth characteristics, perinatal morbidities and clinical practices. Results: out of the 91 premature infants, 59.3% (CI95%=48.9-69.0%) developed EUGR. VTI were observed in 4.4%o of the population; all premature infants affected by VTI had EUGR. The VTI found were syphilis, cytomegalovirus disease and toxoplasmosis. The final analysis has showed a positive association between VTI and EUGR (RR=1.57; CI95%o=1.07-2.30); the female covariables (RR=1.50; CI95%=1.11-2.02), moderate premature classification (RR=1.41; CI95%=1.06-1.87) and small for gestational age (RR=2.69; CI95% 1.853.90) have also influenced this outcome. Conclusion: this study revealed VTI as an important morbidity factor, with impact on the increased risk of EUGR between premature infants affected by these diseases.

Sign in / Sign up

Export Citation Format

Share Document