Perinatal determinants of growth trajectories in children born preterm.

<h4>Background</h4>A growing amount of evidence indicates in utero and early life growth has profound, long-term consequences for an individual's health throughout the life course; however, there is limited data in preterm infants, a vulnerable population at risk for growth abnormal...

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Main Authors: Elizabeth A Jasper, Hyunkeun Cho, Patrick J Breheny, Wei Bao, John M Dagle, Kelli K Ryckman
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0245387
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author Elizabeth A Jasper
Hyunkeun Cho
Patrick J Breheny
Wei Bao
John M Dagle
Kelli K Ryckman
author_facet Elizabeth A Jasper
Hyunkeun Cho
Patrick J Breheny
Wei Bao
John M Dagle
Kelli K Ryckman
author_sort Elizabeth A Jasper
collection DOAJ
description <h4>Background</h4>A growing amount of evidence indicates in utero and early life growth has profound, long-term consequences for an individual's health throughout the life course; however, there is limited data in preterm infants, a vulnerable population at risk for growth abnormalities.<h4>Objective</h4>To address the gap in knowledge concerning early growth and its determinants in preterm infants.<h4>Methods</h4>A retrospective cohort study was performed using a population of preterm (< 37 weeks gestation) infants obtained from an electronic medical record database. Weight z-scores were acquired from discharge until roughly two years corrected age. Linear mixed effects modeling, with random slopes and intercepts, was employed to estimate growth trajectories.<h4>Results</h4>Thirteen variables, including maternal race, hypertension during pregnancy, preeclampsia, first trimester body mass index, multiple status, gestational age, birth weight, birth length, head circumference, year of birth, length of birth hospitalization stay, total parenteral nutrition, and dextrose treatment, were significantly associated with growth rates of preterm infants in univariate analyses. A small percentage (1.32% - 2.07%) of the variation in the growth of preterm infants can be explained in a joint model of these perinatal factors. In extremely preterm infants, additional variation in growth trajectories can be explained by conditions whose risk differs by degree of prematurity. Specifically, infants with periventricular leukomalacia or retinopathy of prematurity experienced decelerated rates of growth compared to infants without such conditions.<h4>Conclusions</h4>Factors found to influence growth over time in children born at term also affect growth of preterm infants. The strength of association and the magnitude of the effect varied by gestational age, revealing that significant heterogeneity in growth and its determinants exists within the preterm population.
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spelling doaj.art-6a29049d6259476ab2fee5c5c8f42efa2022-12-21T17:16:29ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01161e024538710.1371/journal.pone.0245387Perinatal determinants of growth trajectories in children born preterm.Elizabeth A JasperHyunkeun ChoPatrick J BrehenyWei BaoJohn M DagleKelli K Ryckman<h4>Background</h4>A growing amount of evidence indicates in utero and early life growth has profound, long-term consequences for an individual's health throughout the life course; however, there is limited data in preterm infants, a vulnerable population at risk for growth abnormalities.<h4>Objective</h4>To address the gap in knowledge concerning early growth and its determinants in preterm infants.<h4>Methods</h4>A retrospective cohort study was performed using a population of preterm (< 37 weeks gestation) infants obtained from an electronic medical record database. Weight z-scores were acquired from discharge until roughly two years corrected age. Linear mixed effects modeling, with random slopes and intercepts, was employed to estimate growth trajectories.<h4>Results</h4>Thirteen variables, including maternal race, hypertension during pregnancy, preeclampsia, first trimester body mass index, multiple status, gestational age, birth weight, birth length, head circumference, year of birth, length of birth hospitalization stay, total parenteral nutrition, and dextrose treatment, were significantly associated with growth rates of preterm infants in univariate analyses. A small percentage (1.32% - 2.07%) of the variation in the growth of preterm infants can be explained in a joint model of these perinatal factors. In extremely preterm infants, additional variation in growth trajectories can be explained by conditions whose risk differs by degree of prematurity. Specifically, infants with periventricular leukomalacia or retinopathy of prematurity experienced decelerated rates of growth compared to infants without such conditions.<h4>Conclusions</h4>Factors found to influence growth over time in children born at term also affect growth of preterm infants. The strength of association and the magnitude of the effect varied by gestational age, revealing that significant heterogeneity in growth and its determinants exists within the preterm population.https://doi.org/10.1371/journal.pone.0245387
spellingShingle Elizabeth A Jasper
Hyunkeun Cho
Patrick J Breheny
Wei Bao
John M Dagle
Kelli K Ryckman
Perinatal determinants of growth trajectories in children born preterm.
PLoS ONE
title Perinatal determinants of growth trajectories in children born preterm.
title_full Perinatal determinants of growth trajectories in children born preterm.
title_fullStr Perinatal determinants of growth trajectories in children born preterm.
title_full_unstemmed Perinatal determinants of growth trajectories in children born preterm.
title_short Perinatal determinants of growth trajectories in children born preterm.
title_sort perinatal determinants of growth trajectories in children born preterm
url https://doi.org/10.1371/journal.pone.0245387
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