Growth of preterm very low birth weight infants discharged with weight of less than 1500grams
Abstract Early discharge of preterm very low birth weight (VLBW) infants is at times inevitable in low resource settings. The implication of such practice on the growth of this high-risk population is not known. We conducted a retrospective chart review to describe the growth of preterm VLBW infants...
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| Format: | Article |
| Language: | English |
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BMC
2021-03-01
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| Series: | BMC Pediatrics |
| Online Access: | https://doi.org/10.1186/s12887-021-02612-4 |
| _version_ | 1818415567495757824 |
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| author | Yaser Abdallah Flavia Namiiro Jolly Nankunda Jamiru Mugalu Yvonne Vaucher |
| author_facet | Yaser Abdallah Flavia Namiiro Jolly Nankunda Jamiru Mugalu Yvonne Vaucher |
| author_sort | Yaser Abdallah |
| collection | DOAJ |
| description | Abstract Early discharge of preterm very low birth weight (VLBW) infants is at times inevitable in low resource settings. The implication of such practice on the growth of this high-risk population is not known. We conducted a retrospective chart review to describe the growth of preterm VLBW infants discharged with a weight of less than 1500 g. Objectives To describe the growth of discharged preterm VLBW infants over the first 12 weeks. Method Between June 2013 and January 2014; 164 discharged preterm VLBW infants were followed up for 3 months. Among the survivors (132), we identified 111 infant records for this study. Relevant data was entered in STATA for analysis. Growth percentiles were determined at approximately 4 weeks, 8 weeks, and 12 weeks post-discharge using the intergrowth 21st growth charts. Growth velocities were computed using the 2-point average weight model. Regression analysis was used to identify factors associated with growth failure. Growth failure was defined as occipital frontal circumference (OFC), weight, and length < 10th centile by 12 weeks post-discharge. P-value of < 0.05 was considered significant at a 95% confidence interval. Results Among the study infants the median gestational age and weight at birth were 32 weeks (range 28-35 weeks) and 1250 g(range 850-1500 g) respectively; 60/111(54%) were Small for Gestational Age (SGA). The median discharge postmenstrual age (PMA) was 34 weeks (range 30-38 weeks) and weight was 1140 g (range 830-1490 g). The majority 88.2% had not recovered birth weight at discharge of whom 59.1% recovered by 2 weeks and 40.9% recovered between 2 and 4 weeks after discharge. By 12 weeks post-discharge the median PMA and weight were 46 weeks (range 37-51 weeks),and 3110 g (range 1750-5000 g) respectively, 38.7% of the infants had growth failure and 36.9% had OFC <3rd centile. Growth velocity < 15 g/kg/d in the first 4 weeks (OR 3.8, p 0.010) and subsequent 4 weeks (OR 2.5, p 0.049) post-discharge were independently associated with growth failure. Conclusion Slow birth weight recovery was observed and growth failure was prevalent by 12 weeks post-discharge with more than a third having severe microcephaly. Poor post-discharge growth velocity was associated with subsequent growth failure. Recommendations Growth velocity monitoring among preterm VLBW infants should be emphasized. The implication and interventions of this early growth failure needs to be explored. |
| first_indexed | 2024-12-14T11:37:03Z |
| format | Article |
| id | doaj.art-714464d7260a44c588dc7b23017da70d |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-12-14T11:37:03Z |
| publishDate | 2021-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-714464d7260a44c588dc7b23017da70d2022-12-21T23:02:59ZengBMCBMC Pediatrics1471-24312021-03-0121111110.1186/s12887-021-02612-4Growth of preterm very low birth weight infants discharged with weight of less than 1500gramsYaser Abdallah0Flavia Namiiro1Jolly Nankunda2Jamiru Mugalu3Yvonne Vaucher4Department of Paediatrics and Child Health, Makerere University College of Health SciencesDepartment of Paediatrics and Child Health, Mulago National Referral hospitalDepartment of Paediatrics and Child Health, Mulago National Referral hospitalDepartment of Paediatrics and Child Health, Mulago National Referral hospitalDepartment of Pediatrics, Division of Neonatal/Perinatal Medicine, School of Medicine, University of California at San DiegoAbstract Early discharge of preterm very low birth weight (VLBW) infants is at times inevitable in low resource settings. The implication of such practice on the growth of this high-risk population is not known. We conducted a retrospective chart review to describe the growth of preterm VLBW infants discharged with a weight of less than 1500 g. Objectives To describe the growth of discharged preterm VLBW infants over the first 12 weeks. Method Between June 2013 and January 2014; 164 discharged preterm VLBW infants were followed up for 3 months. Among the survivors (132), we identified 111 infant records for this study. Relevant data was entered in STATA for analysis. Growth percentiles were determined at approximately 4 weeks, 8 weeks, and 12 weeks post-discharge using the intergrowth 21st growth charts. Growth velocities were computed using the 2-point average weight model. Regression analysis was used to identify factors associated with growth failure. Growth failure was defined as occipital frontal circumference (OFC), weight, and length < 10th centile by 12 weeks post-discharge. P-value of < 0.05 was considered significant at a 95% confidence interval. Results Among the study infants the median gestational age and weight at birth were 32 weeks (range 28-35 weeks) and 1250 g(range 850-1500 g) respectively; 60/111(54%) were Small for Gestational Age (SGA). The median discharge postmenstrual age (PMA) was 34 weeks (range 30-38 weeks) and weight was 1140 g (range 830-1490 g). The majority 88.2% had not recovered birth weight at discharge of whom 59.1% recovered by 2 weeks and 40.9% recovered between 2 and 4 weeks after discharge. By 12 weeks post-discharge the median PMA and weight were 46 weeks (range 37-51 weeks),and 3110 g (range 1750-5000 g) respectively, 38.7% of the infants had growth failure and 36.9% had OFC <3rd centile. Growth velocity < 15 g/kg/d in the first 4 weeks (OR 3.8, p 0.010) and subsequent 4 weeks (OR 2.5, p 0.049) post-discharge were independently associated with growth failure. Conclusion Slow birth weight recovery was observed and growth failure was prevalent by 12 weeks post-discharge with more than a third having severe microcephaly. Poor post-discharge growth velocity was associated with subsequent growth failure. Recommendations Growth velocity monitoring among preterm VLBW infants should be emphasized. The implication and interventions of this early growth failure needs to be explored.https://doi.org/10.1186/s12887-021-02612-4 |
| spellingShingle | Yaser Abdallah Flavia Namiiro Jolly Nankunda Jamiru Mugalu Yvonne Vaucher Growth of preterm very low birth weight infants discharged with weight of less than 1500grams BMC Pediatrics |
| title | Growth of preterm very low birth weight infants discharged with weight of less than 1500grams |
| title_full | Growth of preterm very low birth weight infants discharged with weight of less than 1500grams |
| title_fullStr | Growth of preterm very low birth weight infants discharged with weight of less than 1500grams |
| title_full_unstemmed | Growth of preterm very low birth weight infants discharged with weight of less than 1500grams |
| title_short | Growth of preterm very low birth weight infants discharged with weight of less than 1500grams |
| title_sort | growth of preterm very low birth weight infants discharged with weight of less than 1500grams |
| url | https://doi.org/10.1186/s12887-021-02612-4 |
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