Extrauterine Growth Restriction in Very Low Birth Weight Infants

Kim, Eun Sun; Sohn, Jin A; Lee, Eun Hee; Choi, Eun Jin; Lee, Hyun Ju; Lee, Jin A; Choi, Chang Won; Kim, Ee Kyung; Kim, Han Suk; Kim, Beyong Il; Choi, Jung Hwan

Abstract

PURPOSE
Extrauterine growth restriction (EUGR) in preterm infants is a major problem in neonatal intensive care units (NICUs) and it has been related to long-term growth deficit and neurodevelopmental issues. The aim of this study was to investigate the frequency of and risk factors for EUGR.
METHODS
The study subjects consisted of very low birth weight (VLBW) infants with a gestational age < or =32 weeks that were born at the Seoul National University Children's Hospital between November 2005 and April 2009. EUGR was defined as weight for gestation, lower than the 10th percentile on discharge.
RESULTS
The frequency of EUGR was 67% (n=111/166). By multiple logistic regression, the presence of small for gestational age (SGA) was the greatest predictor of EUGR, birth weight and daily weight gain during the first 28 days were independent predictors of EUGR. Risk factors for EUGR in non-SGA infants were evaluated because 56% (64/114) of non-SGA infants developed EUGR at discharge. Daily weight gain in the first 28 days was also decreased in EUGR group and independently predicted the risk of EUGR in the non-SGA group.
CONCLUSION
EUGR was a common problem in the NICU. SGA was the most significant predictive factor of the EUGR. Half of the non-SGA infants also developed EUGR, revealing poor weight gain in the early days was as an important predictor. These results support the importance of early nutritional intervention for weight gain which have lagged behind other modern therapeutic interventions when the infant is clinically unstable.