Abstract

A longitudinal and prospective study was carried out at two state-operated maternity hospitals in Belo Horizonte during 1996 in order to assess the weight of preterm appropriate-for-gestational-age newborns during the first twelve weeks of life. Two hundred and sixty appropriate-for-gestational-age preterm infants with birth weight <2500 g were evaluated weekly. The infants were divided into groups based on birth weight at 250-g intervals. Using weight means, somatic growth curves were constructed and adjusted to Count's model. Absolute (g/day) and relative (g kg-1 day-1) velocity curves were obtained from a derivative of this model. The growth curve was characterized by weight loss during the 1st week (4-6 days) ranging from 5.9 to 13.3% (the greater the percentage, the lower the birth weight), recovery of birth weight within 17 and 21 days, and increasingly higher rates of weight gain after the 3rd week. These rates were proportional to birth weight when expressed as g/day (the lowest and the highest birth weight neonates gained 15.9 and 30.1 g/day, respectively). However, if expressed as g kg-1 day-1, the rates were inversely proportional to birth weight (during the 3rd week, the lowest and the highest weight newborns gained 18.0 and 11.5 g kg-1 day-1, respectively). During the 12th week the rates were similar for all groups (7.5 to 10.2 g kg-1 day-1). The relative velocity accurately reflects weight gain of preterm infants who are appropriate for gestational age and, in the present study, it was inversely proportional to birth weight, with a peak during the 3rd week of life, and a homogeneous behavior during the 12th week for all weight groups.

Highlights

  • Preterm neonates are born before maturation of the physiological systems that are essential for extrauterine life

  • Mean weight values were used to construct the curves for longitudinal analysis of weight development of preterm infants who were appropriate for gestational age showing weight and chronological age

  • Growth dynamics is shown in a clear-cut manner and weight loss, stabilization and gain of all curves are graphically similar

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Summary

Introduction

Preterm neonates are born before maturation of the physiological systems that are essential for extrauterine life. Their major problems result from the functional immaturity of these systems. One of the roles played by neonatologists and intensive care units is to support these immature systems through health care strategies designed to overcome some of the limitations. These developments in intensive care have led to a significant decrease in neonatal mortality rates, such as 4.6% in the United States [1] and 13.6% in Brazil [2]. In the past 30 years, no other medical field has demonstrated such a marked decrease in mortality and morbidity, the prematurity rate, ranging from 6 to 10% in the United States, has not shown significant changes in the past 40 years [3].

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