Extrauterine growth restriction in preterm infants: Postnatal growth pattern and physical development outcomes at age 3-6 years

Siyuan Lan; Huanhuan Fu; Rui Zhang; Guimei Zhong; Liya Pan; Fei Bei; Li Hong

doi:10.3389/fped.2022.945422

Extrauterine growth restriction in preterm infants: Postnatal growth pattern and physical development outcomes at age 3-6 years

Front Pediatr. 2022 Jul 29:10:945422. doi: 10.3389/fped.2022.945422. eCollection 2022.

Authors

Siyuan Lan¹, Huanhuan Fu¹, Rui Zhang², Guimei Zhong³, Liya Pan¹, Fei Bei⁴, Li Hong¹

Affiliations

¹ Department of Clinical Nutrition, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
² Department of Pediatrics, Fujian Provincial Maternity and Children's Hospital, Fujian Medical University, Fujian, China.
³ Department of Neonatal Intensive Care Unit, Quanzhou First Hospital, Fujian, China.
⁴ Department of Neonatology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Abstract

Objectives: To investigate the postnatal growth trajectories of preterm infants and evaluate the association between extrauterine growth restriction (EUGR) at discharge and adverse physical growth outcomes at age 3-6 years.

Methods: Premature infants admitted to Shanghai Children's Medical Center within 24 h after birth from 1 January 2016 to 31 December 2018 were enrolled. Neonatal complications, nutrition support, and anthropometric data were collected and analyzed to diagnose EUGR on different definitions at discharge. The weight and the height of each subject were collected by telephone investigation from 1 September 2021 to 31 November 2021 to access the incidences of overweight/obesity, short stature, and thinness at age 3-6 years.

Results: A total of 527 preterm infants were included in the final sample. The overall mean weight and height Z-scores were -0.37 ± 0.97 SD and -0.29 ± 1.18 SD at birth, and increased to -0.03 ± 1.11 SD and 0.13 ± 1.2 SD at follow-up, respectively. The logistic regression analysis indicated longitudinal EUGR on head circumference as the risk factor of overweight or obesity, cross-sectional EUGR on height as the risk factor of short stature, and delayed EN as the risk factor of thinness.

Conclusion: The growth trajectories of the preterm newborns tended toward the normal direction. Longitudinal EUGR on the head circumference and cross-sectional EUGR on height at discharge were associated with adverse physical growth outcomes at age 3-6 years.

Keywords: extrauterine growth restriction; growth pattern; obesity; preterm infants; short stature; thinness.