Neonatal morbidities and postnatal growth failure in very low birth weight, very preterm infants

Abstract

Aim To assess postnatal growth in infants with and without major neonatal morbidities. Methods This study is based on analysis of data collected by the Israel Neonatal Network on VLBW infants (≤1500 g) born in Israel from 2009 to 2018. Postnatal growth was assessed in two 5 years epochs: 2009–2013 (n = 4583) and 2014–2018 (n = 4558). Outcome was considered as severe, mild and no postnatal growth failure (PNGF). Morbidities included respiratory distress syndrome, bronchopulmonary dysplasia, necrotising enterocolitis, patent ductus arteriosus and grades 3–4 intraventricular haemorrhage. Multinomial logistic regression analyses with the generalised estimating equation approach were applied. Results The study population composed 9141 infants. Of them, 2089 had at least one major morbidity and 7052 infants had none. In infants with no morbidities, 2.1% had severe PNGF, 23.7% mild PNGF and 74.2% had no PNGF, as compared to 13.6%, 43.9% and 42.5%, respectively, in infants with any major neonatal morbidity (p < 0.0001). Conclusion Despite enormous advances in neonatal care, postnatal growth remains a challenge in VLBW infants, particularly in infants with major neonatal morbidities. Along with efforts to decrease morbidity, a more personalised plan and follow‐up may be required in infants with major morbidities, given their high risk for diminished growth and potentially, adverse neurodevelopmental outcomes.

Music therapy and weight gain in preterm infants: Secondary analysis of the randomized controlled LongSTEP trial

“…7 Extreme prematurity increased the risk for EUGR in our cohort. However, in contrast to other studies, 8 systemic infection during the NICU stay, gastrointestinal, respiratory, and neurological comorbidities were not significantly associated with EUGR. This could be because most of our cohort had mild comorbidities that did not substantially affect weight gain.…”

“…Of note, despite DC interventions, the EUGR rate of babies born <1500 g (very low birth weight) in our cohort ( n = 109) was approximately 40%, which is consistent with the rates reported in large cohort studies that included NICUs; many without a special emphasis on DC 8,42 . This further demonstrates the complex, multifactorial influences on growth patterns.…”

“…Appropriate growth is an important aspect of health and development during pregnancy, infancy, and childhood 1,2 and is associated with better clinical and neurodevelopmental outcomes for preterm infants 3,4 . The growth of preterm infants is influenced by many elements, including genetic factors, prenatal conditions, degree of prematurity, morbidities, nutrition, and developmental supportive care 5–8 . Monitoring the growth of this sensitive population is complex and requires specific tools and expertise 9–13 .…”

“…3,4 The growth of preterm infants is influenced by many elements, including genetic factors, prenatal conditions, degree of prematurity, morbidities, nutrition, and developmental supportive care. [5][6][7][8] Monitoring the growth of this sensitive population is complex and requires specific tools and expertise. [9][10][11][12][13] Developmentally supportive care (DC) interventions were developed to reduce stress and discomfort and therefore may reduce energy expenditure and allow caloric intake to be used for growth.…”

Growth and differentiation factor 15 (GDF15) levels predict adverse respiratory outcomes in premature neonates

“…They speculated that this might be needed to allow for the catch‐up growth in SGA infants. In the NICU, extrauterine growth retardation increases morbidity in preterm neonates 34 . Higher GDF15 levels could contribute to this phenomenon and thus indirectly modulate other morbidities such as adverse respiratory outcomes.…”