DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20201134

Early weight trends in preterm babies post discharge

Madhura P. Fadnis, Sanjay Prabhu, Shakuntala S. Prabhu

Abstract


Background: Prematurity is the major determinant of morbidity and mortality in newborns. Infants born preterm are at increased risk for impaired growth. The postnatal growth pattern is dependent on biological factors like birth weight, gestational age, sex and intrauterine growth. The present study was undertaken to study the risk factors associated with the preterm delivery and to study the weight gain pattern among the preterm neonates after NICU discharge for a period of one month. Aims and objectives to study the risk factors associated with preterm and to analyze the weight gain pattern of the preterm till one-month post NICU discharge.

Methods: A total of 40 preterm were included during the study period of 2 months, the various maternal risk factors were studied and correlated with preterm delivery. The neonatal complications were studied. The neonates were divided on the basis of their gestational age and birth weight. They were then followed for a period of 1-month post NICU discharge.

Results: There was significant correlation of lower gestational age with neonatal complications and prolonged duration of hospitalization. The weight gain pattern was highly variable with a maximum gain of 188 gm after first week of NICU discharge. Weight gain was significantly more in first week after discharge amongst neonates who had birth weight less than 1.5 kg and also the total weight gain was significantly more in neonates who weighed less than 1.5 kg at birth.

Conclusions: Lower gestational age group 28-32 weeks was significantly associated with neonatal complications and prolonged duration of hospitalization. Immediate follow up of the preterm is necessary as there is wide variability in the weight gain pattern in various gestational age groups.


Keywords


Gestational age, Hospitalization, Neonatal complications, Prematurity, Variability

Full Text:

PDF

References


McCormick MC. The contribution of low birth weight to infant mortality and childhood morbidity. New Eng J Med. 1985 Jan 10;312(2):82-90.

Anon. Practice bulletin ACOG: clinical management guidelines for obstetrician-gynecologists number 31 - assessment of risk factors for preterm birth. Obstet Gynecol. 2001;98:709-16.

March of Dimes, Partnership for Maternal new-born and Child Health, Save the Children, World Health Organization. Howson CP, Kinney MV, Lawn JE, eds. Born Too Soon: The Global Action Report on Preterm Birth (2012). Available at: http://www.who.int/pmnch/media/news/2012/201204_borntoosoon-report.pdf. Accessed 2012.

Doyle LW, Anderson PJ. Adult outcome of extremely preterm infants. Pediatrics. 2010 Aug 1;126(2):342-51.

Turner C, Carrara V, Thien NA, Paw NM, Rijken M, McGready R, et al. Changes in the body weight of term infants, born in the tropics, during the first seven days of life. BMC Pediatr. 2013 Dec 1;13(1):93.

Latal-Hajnal B, von Siebenthal K, Kovari H, Bucher HU, Largo RH. Postnatal growth in VLBW infants: significant association with neurodevelopmental outcome. J Pediatr. 2003 Aug 1;143(2):163-70.

Kang L, Wang H, He C, Wang K, Miao L, Li Q, et al. Postnatal growth in preterm infants during the first year of life: A population-based cohort study in China. PloS One. 2019;14(4): e0213762.

Fenton TR. Preterm Growth Chart 2003 calculations. Available at: http://members. shaw.ca/growthchart/Fenton Growth Chart calculations.xls. Accessed 10 February 2009.

Astbury J, Orgill AA, Bajuk B, Yu VY. Sequelae of growth failure in appropriate for gestational age, very low‚Äźbirthweight infants. Developmental Med Child Neurol. 1986 Aug;28(4):472-9.

Strauss RS, Dietz WH. Growth and development of term children born with low birth weight: effects of genetic and environmental factors. J Pediatr 1998;133:67-72.

Wagura P, Wasunna A, Laving A, Wamalwa D. Prevalence and factors associated with preterm birth at kenyatta national hospital. BMC Pregn Child. 2018 Dec;18(1):107.

Gutbrod T, Wolke D, Soehne B, Ohrt B, Riegel K. Effects of gestation and birth weight on the growth and development of very low birthweight small for gestational age infants: a matched group comparison. Archiv Dis Childhood-Fetal Neon Ed. 2000 May 1;82(3):F208-14.

Lee SK, McMillan DD, Ohlsson A, Pendray M, Synnes A, Whyte R, et al. Variations in practice and outcomes in the Canadian NICU network: 1996-1997. Pediatrics. 2000 Nov 1;106(5):1070-9.

Smith VC, Zupancic JA, McCormick MC, Croen LA, Greene J, Escobar GJ, et al. Trends in severe bronchopulmonary dysplasia rates between 1994 and 2002. J Pediatr. 2005 Apr 1;146(4):469-73.

Stoll BJ, Hansen NI, Adams-Chapman I, Fanaroff AA, Hintz SR, Vohr B, et al. Neurodevelopmental and growth impairment among extremely low-birth-weight infants with neonatal infection. Jama. 2004 Nov 17;292(19):2357-65.

Lee PA, Chernausek SD, Hokken-Koelega AC, Czernichow P. International Small for Gestational Age Advisory Board consensus development conference statement: management of short children born small for gestational age, April 24-October 1, 2001. Pediatrics. 2003 Jun 1;111(6):1253-61.

Tenovuo A. Neonatal complications in small-for-gestational age neonates. Journal of Perinatal Medicine-Official J WAPM. 1988;16(3):197-204.

Mathew G, Gupta V, Santhanam S, Rebekah G. Postnatal weight gain patterns in preterm very-low-birth-weight infants born in a tertiary Care Center in South India. J Trop Pediatr. 2018 Apr;64(2):126-31.

Saluja S, Modi M, Kaur A, Batra A, Soni A, Garg P, et al. Growth of very low birth-weight Indian infants during hospital stay. Ind Pediatr. 2010 Oct 1;47(10):851-6.

Fenton TR, Nasser R, Eliasziw M, Kim JH, Bilan D, Sauve R. Validating the weight gain of preterm infants between the reference growth curve of the fetus and the term infant. BMC Pediatr. 2013 Dec;13(1):92.

Ehrenkranz RA, Younes N, Lemons JA, Fanaroff AA, Donovan EF, Wright LL, et al. Longitudinal growth of hospitalized very low birth weight infants. Pediatrics. 1999 Aug 1;104(2):280-9.

Das S, Bhattacharya M, Sanyal D, Basu S, Chatterjee A, Paul DK, et al. Growth and neurodevelopmental outcome of neonatal intensive care Unit graduates till 1 year at a tertiary care centre in eastern India and identification of the clinical and electrophysiological predictors of adverse developmental outcome. J Pediatr Res. 2017;4(02):157-68.

Padmaja D, Mohanty NC. Morbidity and Mortality of NICU Graduates - One Year Follow-up. New Ind J Pediatr. 2016;5(02):61-6.