Prediction of extrauterine growth retardation (EUGR) in VVLBW infants

Background: Long-term growth failure in very very low birth weight (WLBW) infants is a common complication of extreme prematurity. Critical illnesses create challenges to adequate nutriture. Purpose: To identify predictors of extrauterine growth retardation (EUGR) in WLBW infants and to evaluate their nutritional intake and subsequent growth. Study Design: A 4-year retrospective chart review of 221 infants ≤ 1000 g birth weight and ≤ 29 weeks gestational age who were admitted within 24 hours of birth, were free of major congenital anomalies and survived at least 7 days. Daily intakes and anthropomorphic data were collected and analyzed. Significant events during hospitalization were documented. Results: Mean energy and protein intakes during hospitalization did not reach recommendations of 120 kcal/kg/d and 3.0 g/kg/day. In utero growth rates could not be consistently reached or sustained. As expected, BW (as measured by BW percentile score) was highly predictive of EUGR (p<0.001). When the independent effect of other predictors of EUGR was considered, only days of total parenteral nutrition (p<0.001) and HC percentile at return to birth weight (p<0.001) made a significant contribution to the prediction of EUGR, once the effect of BW was taken into account.