376 Postnatal Growth Restriction in VLBW Infants in Spanish NICUs. A Multicentric Study(SEN 1500 Network).

Abstract

OBJECTIVE: To study postnatal growth restriction from birth to discharge, in VLBW infants <33 weeks admitted in all 55 NICUs of SEN 1500 Network. To study their differences related to perinatal morbidity and NICU type. METHODS: 2317 infants were included in SEN 1500 Network during 2002–2003. Weight was evaluated at birth, at 28 days, at 36 postconceptional weeks (PCA) and at discharge. Height and head circumference progression was also evaluated. Local intrauterine growth charts were used to analyze growth and z score changes. Lineal regression analysis was used to compare changes in z score weight from birth to 28 days of life, to the 120 perinatal variables collected in the Network. RESULTS: In this population, birth weight was 1111g (SD 238), gestational age 29 weeks (SD 2.1) and discharge age 66 days (SD 66). During the first 28 days of life weight gain was 10.7 g/day (SD 6.4). Mean Z score fall from -0.66 (SD 1.3) at birth to -2.54 at 28 days (SD 1.3) and to -3.12(SD 1.7)at 36 weeks of PCA. At discharge, weight and height restriction (74–81% of infants <10p) was more important than head circumference restriction (32–42%of infants <10p). Using difference in weight Z scores between birth and 28th day as dependent variable, predictor variables selected by the model were: antenatal steroids, gestational age, place of birth, NICU type, CRIB score, PDA and late bacterial sepsis. These variables only explained the 14.1% of growth restriction. CONCLUSION: VLBW infants <33 w of SEN 1500 Network have a severe extrauterine growth restriction compared to intrauterine growth patterns. This restriction is greater during the first 28 days of life. Perinatal and neonatal morbidity can explain only the 14% of this restriction. There are significant differences in growth restriction among NICUs.