Factors associated with extrauterine growth restriction in very-low-birth-weight infants: A retrospective study in Japan.

BACKGROUND

Very-low-birth-weight infants (VLBWIs) are at risk of extrauterine growth restriction (EUGR), which is associated with poor neurodevelopmental outcomes. This study aimed to determine the incidence of EUGR in VLBWIs and the factors associated with EUGR using a longitudinal definition.

METHODS

Data of infants with birth weights <1500 g admitted to a university hospital in Tokyo were collected from medical records. Longitudinal EUGR was defined as a loss of weight and head circumference exceeding one standard deviation score between birth and 36 weeks of postmenstrual age.

RESULTS

In total, 334 VLBWIs participated in this study. Longitudinal EUGR incidence for weight and head circumference were 31.4 % and 38.3 %, respectively. In the multivariate analysis, significant risk factors for longitudinal EUGR based on weight and head circumference were congenital heart disease and a greater number of days to reach 150 ml/kg/day by enteral feeding.

CONCLUSIONS

This study was the first to demonstrate that congenital heart disease was associated with EUGR using a longitudinal definition. Furthermore, the rate of increase in volume of enteral feeding was crucial for VLBWIs to maintain growth rates during hospitalization.