A longitudinal evaluation of growth outcomes at hospital discharge of very-low-birth-weight preterm infants

Background/Objectives: To quantify the rate of progressive failure of very-low-birth-weight (VLBW) infants over time in the neonatal intensive care unit to meet growth milestones. Subjects/Methods: In a prospective longitudinal study, 114 VLBW preterm infants (<= 1500 g) of both sexes, with normal and/or low weight for gestational age were included. At the start, weight, length, mid-upper arm (MUAC), thigh and cephalic circumferences were measured. Weight/age (W/A), length/age and weight/length (+/- 2 z-score) indices were calculated. All measurements were taken at inclusion, at 7, 15 and 30 days of hospitalization. Chi-square test, analysis of variance and repeated-measures tests were estimated. Results: Thirteen cases (14%) died and were excluded soon after the first determinations. In all, 9 (8.9%) died during the study, 12 (11.9%) were discharged before 30 days of life and 80 (79.2%) completed the study. At 7 days, the percentage of preterm infants with an index of W/A <-2 z-scores increased from 44 to 67% (44-68 subjects; P<0.01), with no changes afterwards; the indicator MUAC <-2 z-scores increased at 7 days from 23 to 49% (23-49 subjects); at 15 from 23 to 65% (23-61 subjects) and at 30 days from 23 to 79% (23-63 subjects; P<0.001). Conclusions: Clinicians could use these indicators for earlier detection of growth failure in VLBW infants in order to target more aggressive nutrition early. European Journal of Clinical Nutrition (2012) 66, 474-480; doi:10.1038/ejcn.2011.191; published online 16 November 2011