Prospective observational study to assess the Somatic Growth in Very Low Birth Weight infants

Abstract

Background: The birth weight is the first weight measured; an infant with low birth weight is more likely to have poor somatic growth during childhood and develop markers of metabolic risk factors at his/her later age. Objectives: To evaluate the somatic growth of very low birth weight (VLBW) infants at discharge and 40 weeks postmenstrual age and to compare the growth of small for gestational age (SGA) and appropriate for gestational age (AGA) babies. Methods: This prospective observational study was conducted over a period of one year at the neonatal unit and high-risk follow-up clinic of a tertiary care hospital. VLBW babies (weight less than 1500 g), admitted within 72 hours of life and discharged alive, were followed up prospectively. The baseline data were collected before discharge from the hospital and babies were followed up till the 40 weeks post-menstrual age. Results: Out of 53 babies enrolled, one baby had a congenital malformation, six died during NICU stay, and four were not followed up. Finally, 42 babies were followed for 40 weeks. The mean gestational age was 30 ± 2.5 weeks and mean birth weight was 1199 ± 216 gm. The mean Z scores for weight, length and head circumference at birth were -0.88, -0.59, and -0.64, respectively. These changed to -1.12, -1.12, and -1.11, respectively at the time of discharge and -1.69, -1.03, and -0.73, respectively at post-menstrual age of 40 weeks. Both SGA and AGA infants exhibited a growth lag during hospital stay as indicated by a fall in Z scores for all three parameters from birth to discharge. Exclusive enteral feeding is feasible for VLBW infants without any difference in growth compared to babies given short term parenteral nutrition. Despite aggressive enteral feeding, only one baby had NEC and none of the babies developed late onset sepsis. Conclusions: In our study, both SGA and AGA infants exhibited a growth lag during hospital stay as indicated by a fall in Z scores for all three parameters from birth to discharge. Exclusive enteral feeding is feasible for VLBW infants without any difference in growth compared to babies given short-term parenteral nutrition. Also, rapid progression of feeds did not have any significant adverse effects in our study population.