Abstract

The early postnatal weight loss (EPWL) is highly variable in the extremely low birth weight infants (birth weight <1000 g, ELBW). It is reported to be unassociated with adverse outcomes within a range of 3-21% of birth weight. Its wide range might have contributed to this lack of association. The aim of our paper is to study the effects of maximum EPWL, graded as low, medium and large on clinical outcomes in ELBW infants. In a retrospective cohort observational study EPWL was measured as maximum weight loss from birth weight (MWL) in ELBW infants and grouped as low (5-12%) moderate (18.1-12%) and high (18-25%). The clinical course and complications of infants were compared between the groups. Gestational age (GA) was highest and surfactant administration, peak inspiratory pressure requirement, fluid intake, urinary output, oxygen dependent days and the number of oxygen dependent infants at age 28 days were lower in the low MWL compared to the high MWL group. However, all these significant P-values declined after controlling for GA. Diabetes mellitus and pregnancy associated hypertension were not noted in mothers in high MWL group, whereas 38% of mothers in low MWL group suffered from the latter (P=0.05). Maximum postnatal transitional weight loss, assessed in the range of low, moderate and high, is not associated with adverse outcomes independent of gestational age in ELBW infants. Maternal hypertension decreases EPWL in them.

Highlights

  • Postnatal weight loss (EPWL) is an important physiological component of normal transition to extra uterine life.[1,2,3,4] It represents the postnatal contraction of an expanded fetal extracellular water volume (ECW).[2]

  • The abnormal postnatal persistence of high intra uterine ECW has been associated with significant morbidities in premature neonates, Early postnatal weight loss (EPWL) in the wide range of 3-21% is not independently correlated with major diseases attributed to abnormal body water metabolism in extremely low birth weight infants (ELBW, birth weight

  • In this study we evaluated the association of maximum EPWL, graded as low, medium and high, with morbidities which are related to water metabolism in ELBW infants

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Summary

Introduction

Postnatal weight loss (EPWL) is an important physiological component of normal transition to extra uterine life.[1,2,3,4] It represents the postnatal contraction of an expanded fetal extracellular water volume (ECW).[2] Whereas, the abnormal postnatal persistence of high intra uterine ECW has been associated with significant morbidities in premature neonates, EPWL in the wide range of 3-21% is not independently correlated with major diseases attributed to abnormal body water metabolism in extremely low birth weight infants (ELBW, birth weight

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