Risk factors and outcomes of extrauterine growth restriction in extremely low birth weight infants

Abstract

Objective To explore risk factors and outcomes of extrauterine growth restriction(EUGR)in extremely low birth weight infants(ELBWI). Methods A retrospective analysis was performed on the clinical data of ELBWI in NICU of Shengjing Hospital from Jan.1st 2012 to Jun.31st 2017.These subjects were classified into EUGR(Z-score≤-2)and non-EUGR groups(Z-score>-2)based on the body weight at discharge.The risk factors for the occurrence of EUGR and outcomes were studied by multivariate logistic regression analysis. Results A total of 154 cases were enrolled.One hundred and ten cases with gestational age of(28.9±1.7)weeks met the criteria of EUGR(Z-score: -2.64±0.73)as case group, which include 62 males and 48 females.Other 44 cases with gestational age of(27.8±1.3)weeks were no-EUGR(Z-score: -1.53±0.34)as control group, which include 26 males and 18 females.The abnormality of umbilical blood flow(27.3% vs 9.1%, P=0.017)and IUGR ratio(14.5%vs 0%, P=0.006)in case group were higher than those in control group.Birth weight in case group was much lower[904(816, 960)g]vs[947(912, 971)g], P=0.008.The late onset sepsis(58.2% vs 38.6%, P=0.033)and cholestasis(40.9% vs 18.2%, P=0.008)ratio were higher in case group.Logistic regression analysis indicated that the longer total time of feeding interruption(OR=3.174, P=0.034)and cholestasis(OR=8.062, P=0.043)were the independent risk factors for EUGR. Conclusion The causes of EUGR were multi-factorial.The ratio of abnormality of umbilical blood flow and IUGR were higher.The birthweight were much lower in in case group.Feeding intolerance and cholestasis are the independent risk factors for EUGR. Key words: Extrauterine growth restriction; Risk factor; Extremely low birth weight infant