Carlos Zozaya1, Alejandro Avila-Alvarez2, Luis Arruza3, Fermín García-Muñoz Rodrigo4, Cristina Fernandez-Perez5, Abdón Castro6, María Teresa Cuesta7, Beatriz Vacas8, María L Couce9, Máximo Vento Torres10, Miguel Saenz de Pipaón11. 1. Division of Neonatology, Hospital for Sick Children, Toronto, Ontario, Canada, carlos.zozaya@sickkids.ca. 2. Neonatal Unit, Department of Paediatrics, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain. 3. Division of Neonatology, Hospital Clínico San Carlos, Madrid, Spain. 4. Division of Neonatology, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain. 5. Division of Preventive Medicine, Hospital Clínico San Carlos, Madrid, Spain. 6. Neonatal Unit, Department of Pediatrics, Complejo Hospitalario de Navarra - Hospital Virgen del Camino, Pamplona, Spain. 7. Neonatal Unit, Department of Paediatrics, Hospital Infanta Cristina, Parla, Spain. 8. Neonatal Unit, Complejo Asistencial de Salamanca, Salamanca, Spain. 9. Neonatology Department, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain. 10. Neonatology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain. 11. Neonatology Department, Hospital Universitario La Paz, Madrid, Spain.
Abstract
BACKGROUND: Extrauterine growth restriction is common in the preterm infant, and it is associated with poor neurodevelopment. Nutrition plays an important role in postnatal growth, but growth is also influenced by other factors like co-morbidity, and, also, there might be sex differences. METHODS: This is a cohort study including preterm infants < 32 weeks at birth (n = 21,825) from the Spanish Neonatal Network database. The effect of sex and morbidity (patent ductus arteriosus, bronchopulmonary dysplasia, necrotizing enterocolitis and late-onset sepsis) on weight gain as well as linear and head growth from birth to discharge/death was assessed with linear regression models adjusted by gestational age and Z-scores at birth. RESULTS: The 4 selected morbidities had an independent effect on all 6 growth parameters studied, which was greater in the case of necrotizing enterocolitis: changes in weight, length and head Z-scores were -0.60 (95% CI: -0.66 to -0.55), -0.62 (95% CI: -0.70 to -0.54) and -0.63 (95% CI: -0.71 to -0.56), respectively. Weight gain and linear growth were overall more affected than head growth. Girls lost slightly more weight Z-scores (-0.03; 95% CI: -0.06 to -0.002) than boys after adjustment by morbidity. There were no significant gender differences regarding linear and head growth velocity (cm/week), although girls lost more head Z-scores (-0.14; 95% CI: -0.18 to -0.10). CONCLUSIONS: Main co-morbidities associated with prematurity have an impact on postnatal growth. Head growth is less affected than length and weight. Girls are at slightly higher risk of postnatal weight and head restriction after adjustment by morbidity.
BACKGROUND: Extrauterine growth restriction is common in the preterm infant, and it is associated with poor neurodevelopment. Nutrition plays an important role in postnatal growth, but growth is also influenced by other factors like co-morbidity, and, also, there might be sex differences. METHODS: This is a cohort study including preterm infants < 32 weeks at birth (n = 21,825) from the Spanish Neonatal Network database. The effect of sex and morbidity (patent ductus arteriosus, bronchopulmonary dysplasia, necrotizing enterocolitis and late-onset sepsis) on weight gain as well as linear and head growth from birth to discharge/death was assessed with linear regression models adjusted by gestational age and Z-scores at birth. RESULTS: The 4 selected morbidities had an independent effect on all 6 growth parameters studied, which was greater in the case of necrotizing enterocolitis: changes in weight, length and head Z-scores were -0.60 (95% CI: -0.66 to -0.55), -0.62 (95% CI: -0.70 to -0.54) and -0.63 (95% CI: -0.71 to -0.56), respectively. Weight gain and linear growth were overall more affected than head growth. Girls lost slightly more weight Z-scores (-0.03; 95% CI: -0.06 to -0.002) than boys after adjustment by morbidity. There were no significant gender differences regarding linear and head growth velocity (cm/week), although girls lost more head Z-scores (-0.14; 95% CI: -0.18 to -0.10). CONCLUSIONS: Main co-morbidities associated with prematurity have an impact on postnatal growth. Head growth is less affected than length and weight. Girls are at slightly higher risk of postnatal weight and head restriction after adjustment by morbidity.
Authors: Jung Ho Han; So Jin Yoon; Joo Hee Lim; Jeong Eun Shin; Ho Seon Eun; Min Soo Park; Kook In Park; Soon Min Lee Journal: Eur J Pediatr Date: 2021-07-08 Impact factor: 3.183
Authors: David Ramiro-Cortijo; Ángel Luis López de Pablo; Ma Rosario López-Giménez; Camilia R Martin; Joanne Brown; Miguel Saenz de Pipaón; Silvia M Arribas Journal: Nutrients Date: 2020-01-01 Impact factor: 5.717