Growth of premature neonates admitted in a level III neonatal unit

Abstract

Problem consideredThe gold standard for postnatal growth for preterm neonates is their intrauterine growth standard. Extra uterine growth restriction (EUGR) implies weight less than minus 2 Z scores at discharge.1 MethodsA prospective observational study of preterm neonates admitted at the level III neonatal unit of a tertiary care teaching hospital. Growth parameters (weight, length and head circumference) were recorded on admission, during hospitalization, at discharge and at term gestation. Z scores were calculated using Fenton's growth charts.13,14 Growth velocity was calculated for weight, length and head circumference (HC). ResultsThe incidence of EUGR was 64.8% at discharge and 76.8% at term. Mean Z scores for weight, length and head circumference in neonates with EUGR and without EUGR were −1.36 ± 0.80 vs −0.40 ± 0.63 (p = 0.000), −1.21 ± 1.27 vs −0.38 ± 0.90 (p = 0.000), −1.35 ± 1.04 vs −0.44 ± 1.02 (p = 0.000) respectively at birth, −2.84 ± 0.60 vs −1.38 ± 0.79 (p = 0.000), −1.92 ± 1.26 vs −0.85 ± 0.88 (p = 0.000), & −1.85 ± 1.10 vs −0.88 ± 1.11 (p = 0.000) respectively at discharge & −2.84 ± 1.18 vs −2.44 ± 1.16 (p = 0.102), −2.44 ± 1.33 vs −1.95 ± 1.29 (p = 0.071) & −2.03 ± 1.14 vs −1.28 ± 1.61 (p = 0.005) respectively at term.Mean growth velocities for neonates with EUGR and without EUGR were 7.98 ± 4.63 vs 10.85 ± 5.53 g/kg/day (p = 0.120) for weight, 0.65 ± 0.24 vs 0.72 ± 0.37 cm/week (p = 0.924) for length and 0.43 ± 0.14 vs 0.41 ± 0.15 cm/week (p = 0.439) for head circumference at discharge and 12.99 ± 8.54 vs 12.70 ± 7.58 g/kg/day (p = 0.924), 0.72 ± 0.35 vs 0.62 ± 0.22 cm/week (p = 0.145) and 0.49 ± 0.16 vs 0.43 ± 0.14 cm/week (p = 0.048) respectively for weight, length and head circumference at term. ConclusionAbout two third premature neonates at discharge and three fourths at term had EUGR. Growth velocity for HC was significantly more in neonates with EUGR by term gestation indicating a brain sparing effect.