Postnatal length and weight growth velocities according to Fenton reference and their associated perinatal factors in healthy late preterm infants during birth to term-corrected age: an observational study

BackgroundOptimum early postnatal growth is critical for early and later health of preterm infants. Postnatal length and weight growth velocities and their associated perinatal factors in healthy late preterm infants without restriction of neonatal complications and nutritional problems have not been widely studied.MethodsAs part of ongoing longitudinal follow-up study of growth and development of preterm infants in Shandong Qianfoshan Hospital in China, 599 healthy late preterm infants without neonatal complications and nutritional problems were sampled from 795 preterm infants born in January 2014 to April 2017. Perinatal factors, growth parameters, growth velocities(LengthZ and WeightZ: Z-score changes of length and weight) during birth and term-corrected age were documented. Associated variables of growth velocities were analyzed by bivariate and multivariate regression analyses. Adjusted LengthZ and WeightZ were compared between/among subgroups of associated variables using analysis of covariance. Catch-up growth were defined as LengthZ or WeightZ >0.67.ResultsThe mean LengthZ and WeightZ were 0.28, 0.65, respectively. Catch-up growth of length and weight was ubiquitous(30.7, 46.2%, respectively). Faster length growth velocity was associated with male, larger postmenstrual age(PMA) at birth, younger mother and larger PMA at visit; Faster weight growth velocity was associated with male, unfavorable intrauterine growth status defined by birth weight percentile(Small-for-Gestational-Age(<P10), Appropriate-for-Gestational-Age(P10-90), Large-for-Gestational-Age(>P90)), twin and larger PMA at visit. When adjusted for associated co-variables, weight catch-up growth existed in subgroups of 36weeks PMA at birth, male, twin and SGA, while AGA almost reached this standard with mean adjusted WeightZ as 0.66. Although none of these subgroups got length catch-up growth standard, infants of 36weeks PMA at birth had statistically rapider length growth velocity than 34 and 35weeks PMA at birth subgroups(mean adjusted LengthZs of 34, 35 and 36weeks subgroups: 0.10, 0.22, 0.38, respectively).ConclusionsPostnatal length and weight growth velocities of healthy late preterm infants from birth to term-corrected age were much superior than that of Fenton reference, especially for weight, with ubiquitous catch-up growth. Different associated factors for length and weight growth signified the necessity of constructing more detailed growth standards by specific stratification for associated factors.