Objectives: To evaluate the growth pattern of Very Low Birth Weight (VLBW) infants (birthweight <1500 g) during hospital stay and to compare the growth of Small for gestational age (SGA) and Appropriate for gestational age (AGA) infants.
Study design: Prospective observational study. SETTING. Level III Neonatal Intensive Care Unit (NICU) in Northern India.
Participants: A cohort of 97 VLBW infants, admitted to NICU at Sir Ganga Ram Hospital, from 1 January, 2007 to 31 July, 2008. INTERVENTION/MEASUREMENT: Weight, length and head circumference (HC) were serially measured from birth till discharge and respective Z scores were calculated as per data from Fentons references. Growth was also assessed by superimposing these trends on Ehrenkranzs postnatal growth charts.
Results: The mean Z scores for weight, length and HC at birth were -1.17, -1.09 and -0.54, respectively. These decreased to -2.16, -2.24 and -1.35, respectively by discharge. Both SGA and AGA infants exhibited a decrease of approximately 1 Z score in all parameters. On postnatal charts, growth of infants remained at or above respective reference lines, except in those below 1000 g at birth. Average daily weight gain after regaining birth weight was 15.18 ± 1.7 g/kg/d, whereas the increase in HC and length were 0.48 ± 0.2 cm/week and 0.60 ± 0.4 cm/week, respectively. These increments when compared to the intrauterine growth rates, indicated discrepant growth trends.
Conclusions: VLBW infants suffered significant growth lag during NICU stay and exhibited disproportionately slow growth of HC and length.