Extrauterine growth restriction at discharge in very-low-birth weight infants: a retrospective study in a level III neonatal intensive care unit.

Abstract

Extrauterine growth restriction (EUGR) remains a serious problem among very low birth weight (VLBW) infants and is a marker of severe nutritional deficit during the first weeks of life. It can lead to a higher risk of growth impairment during childhood and long-term medical problems. The aim of this study is to determine the prevalence and risk factors of EUGR in preterm infants below 1500 grams. Descriptive retrospective study of all preterm infants with birth weight below 1500 grams who were born at and discharged from our center, from January 1st, 2012 to December 31st, 2016. Those with major congenital malformations, congenital TORCH infections, death before 36 weeks of postmenstrual age and those transferred during hospitalization were excluded. A total of 101 VLBW newborns were studied, 35 (34.7%) had EUGR. Fifty-four (52.9%) newborns were male. The median gestational age was 29 weeks (25-35) and the median birth weight was 1205 grams (580-1500). Fetal growth restriction, moderate-severe bronchopulmonary dysplasia, invasive mechanical ventilation, patent ductus arteriosus and its surgical treatment, retinopathy of prematurity, cystic periventricular leukomalacia, anemia requiring red blood cells transfusions, as well as duration of parenteral nutrition, day of start of enteral nutrition (EN), day of achievement of full EN and a longer duration of hospitalization were identified as independent risk factors for EUGR. EUGR is a serious concern in neonatal intensive care. Some of its potential long-term consequences include a higher risk of growth impairment during childhood, poorer neurodevelopment and motor outcomes, as well as cardiovascular disease and type II diabetes later in life. Therefore, it is necessary to carefully assess the nutritional status of VLBW infants, as well as to increase the knowledge of the risk factors for EUGR, which will be crucial for its prevention.