Vertically transmitted infections and extrauterine growth restriction in preterm neonates: a new risk factor

Abstract

Objectives: to investigate the association between Vertically Transmitted Infections (VTI) and Extrauterine Growth Restriction (EUGR) among premature infants in Neonatal Intensive Care Units (NICU). Methods: part of a large non-concurrent cohort study with medical records analysis. We evaluated EUGR in premature infants at a gestational age at birth of > 32 weeks and <36 weeks and presented a corrected gestational age of 36 completed weeks during a 27-day birth follow-up. Premature infants with major congenital anomalies were excluded. We analyzed associations among EUGR, VTI and covariables related to maternal disease, birth characteristics, perinatal morbidities and clinical practices. Results: out of the 91 premature infants, 59.3% (CI95%=48.9-69.0%) developed EUGR. VTI were observed in 4.4%o of the population; all premature infants affected by VTI had EUGR. The VTI found were syphilis, cytomegalovirus disease and toxoplasmosis. The final analysis has showed a positive association between VTI and EUGR (RR=1.57; CI95%o=1.07-2.30); the female covariables (RR=1.50; CI95%=1.11-2.02), moderate premature classification (RR=1.41; CI95%=1.06-1.87) and small for gestational age (RR=2.69; CI95% 1.853.90) have also influenced this outcome. Conclusion: this study revealed VTI as an important morbidity factor, with impact on the increased risk of EUGR between premature infants affected by these diseases.

Enteral nutritional therapy of premature newborns (<1,500g) admitted to a neonatal intensive care unit

“…Segundo Embleton, Pang e Cooke (2001) o crescimento pós-natal de RNPT deve ser semelhante ao que ocorre intra-útero, tanto na velocidade de crescimento como na composição corporal. Tem-se observado, em diversos serviços, a ocorrência universal de restrições de C O N C I L I U M | 218 crescimento após o nascimento, com maior incidência no grupo de neonatos prematuros (VIEIRA, et al 2021).…”

“…Estão envolvidos na RCEU os fatores genéticos e ambientais, incluindo a nutrição inadequada durante o período fetal e neonatal, hospitalizações, tratamentos medicamentosos instituídos, anormalidades endócrinas e morbidades relacionadas à própria prematuridade (VIEIRA, et al 2021).…”