Early growth and development of extremely / very low birth weight infants after discharge

Abstract

Objective To investigate the early growth and development of extremely low birth weight infants (ELBWI) and very low birth weight infants (VLBWI) through a follow-up study from hospital discharge until 18 months of corrected age. Methods ELBWI and VLBWI who were hospitalized and discharged alive from the Neonatal Intensive Care Unit of Hunan Children's Hospital from January 2013 to June 2014 were recruited. Follow-ups were performed at the corrected age of 40 weeks, as well as at one, three, six, 12 and 18 months of corrected age. Several parameters indicating the growth and development of those infants were monitored and assessed. Extrauterine growth retardation (EUGR) was defined as head circumference (HC) or weight≤10th percentile for gestational age at discharge. T-, rank-sum, or Chi-square (or Fisher's exact) test was performed for statistical analysis. Results (1) A total of 285 ELBWI and VLBWI were recruited. Among them, 145 (50.9%) were alive at last follow-up, 37 (13.0%) died, and 103 (36.1%) were lost. No significant differences in clinical data were observed between the infants who completed the follow-up and those who did not (all P>0.05). (2) Based on HC and weight, the incidences of EUGR in the 145 infants reached the peak at the corrected age of three months [42.8% (62/145) and 40.0% (58/145)], and then declined with increasing age. At 18 months of corrected age, the incidences of EUGR dropped to 31.7% (46/145) and 14.5% (21/145), respectively. (3) There were no significant differences in gender, gestational age, birth weight, length of hospital stay, duration of oxygen therapy, and incidences of complications between the infants with and without EUGR (all P>0.05). (4) The rate of pulmonary surfactant therapy in neonates with EUGR was lower than in those without [27.8% (15/54) vs 53.8% (49/91), χ2=9.340, P 0.05). Neither HC nor weight at the corrected age of 18 months showed significant differences between the two groups (both P>0.05). (5) At 18 months of corrected age, 31.7% (46/145) of the infants had their HC≤10th percentile, and 14.5% (21/145) had their weight≤10th percentile. Infants with HC≤10th percentile were at higher risk of abnormal neurodevelopment than those with HC >10th percentile [67.4% (31/45) vs 40.4% (40/99), χ2=9.154]. Infants with either HC or weight ≤10th percentile had higher risk of abnormal neurodevelopment that those with both HC and weight >10th percentile [65.5% (36/55) vs 38.9% (35/90), χ2=9.641] (both P>0.05). Conclusions ELBWI/VLBWI are at high risk of growth retardation. Incidence of growth restriction declines with age. Key words: Infant, extremely low birth weight; Infant, very low birth weight; Growth and development; Growth disorders; Follow-up studies