Abstract
We aimed to evaluate risk factors for growth failure in very low birth weight (VLBW) infants at 18–24 months of corrected age (follow-up1, FU1) and at 36 months of age (follow-up2, FU2). In this prospective cohort study, a total of 2,943 VLBW infants from the Korean Neonatal Network between 2013 and 2015 finished follow-up at FU1. Growth failure was defined as a z-score below -1.28. Multiple logistic regression was used to analyze risk factors for growth failure after dividing the infants into small for gestational age (SGA) and appropriate for gestational age (AGA) groups. Overall, 18.7% of infants were SGA at birth. Growth failure was present in 60.0% at discharge, 20.3% at FU1, and 35.2% at FU2. Among AGA infants, male sex, growth failure at discharge, periventricular leukomalacia, treatment of retinopathy of prematurity, ventriculoperitoneal shunt status and treatment of rehabilitation after discharge were independent risk factors for growth failure at FU1. Among SGA infants, lower birth weight, pregnancy-induced hypertension, and treatment of rehabilitation after discharge were independent risk factors for growth failure at FU1. Mean weight z-score graphs from birth to 36 month of age revealed significant differences between SGA and non-SGA and between VLBW infants and extremely low birth weight infants. Growth failure remains an issue, and VLBW infants with risk factors should be closely checked for growth and nutrition.
Highlights
Optimum postnatal growth in early infancy is critical for lowering metabolic and chronic diseases later in life and improving neurodevelopment in preterm infants [1,2,3]
Data were extracted from the Korean Neonatal Network (KNN) database, which comprises data collected prospectively from 89 units across Korea; the data accounts for the care of more than 70% of very low birth weight (VLBW) infants born in Korea
Duration of neonatal intensive care unit (NICU) admission was relatively shorter than the post-discharge period until FU1, we found that independent risk factors for growth failure at FU1 in small for gestational age (SGA) infants were mainly pregnancy-induced hypertension, lower birth weight in addition to the rehabilitation treatment
Summary
Optimum postnatal growth in early infancy is critical for lowering metabolic and chronic diseases later in life and improving neurodevelopment in preterm infants [1,2,3]. Preterm survival without major morbidities has improved in recent years through rapid evolvement of treatment strategies, it is unclear whether or not growth rates are better. Postnatal growth failure is typically diagnosed when an infant weigh less than the 10th percentile or has a weight z-score below -1.28 at discharge or at a postmenstrual age of 36-40-weeks [4].
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