Risk factors for extrauterine growth retardation in moderate and late preterm infants

Abstract

Objective To study the incidence and risk factors for extrauterine growth retardation (EUGR) at discharge in moderate and late preterm infants. Methods A retrospective analysis was performed on 607 premature infants who were admitted to the neonatal intensive care unit between January 1st, 2016 and December 31st, 2016.These subjects were classified into EUGR (n=159) and non-EUGR groups (n=448) based on the body weight at discharge.The risk factors for the occurrence of EUGR were studied by multivariate logistic regression analysis. Results Based on the body weight, the incidence of EUGR at discharge was 26.2%(159/607). The incidence of EUGR in intrauterine growth restriction (IUGR) infants was significantly higher than in non-IUGR infants (P<0.001). The very low birth weight (VLBW) infants had a higher incidence of EUGR than non-VLBW infants (P<0.05). Compared with the non-EUGR group, the fasting time, the age to achieve full enteral feeds, the length of mechanical ventilation, oxygen therapy and the length of hospital stays were significantly greater in the EUGR group (P<0.05). The percentages of caesarean section, multiple gestation, pregnancy-induced hypertension, intrahepatic cholestasis of pregnancy and umbilical cord abnormality in the EUGR group were higher than in the non-EUGR group(P<0.05). The incidences of septicemia, hypoalbuminemia, anemia, retinopathy of prematurity, brain injury in premature infants and mechanical ventilation in the EUGR group were higher than in the non-EUGR group(P<0.05). The logistic regression analysis showed that birth weight, IUGR, multiple gestation, abnormality of umbilical cord and the length of hospital stays were the independent risk factors for EUGR. Conclusion The causes of EUGR are multi-factorial.To strengthen pregnancy care, aggressive and reasonable nutritional strategy, prevention and treatment of complications may facilitate to reduce the occurrence of EUGR. Key words: Premature infant; Extrauterine growth retardation; Intrauterine growth retardation; Retinopathy of prematurity