Extrauterine Growth Restriction among Very Low Birth Weight Neonate using Intergrowth 21st in a Neonatal Intensive Care Unit: A Retrospective Study

Introduction: Extrauterine growth restriction (EUGR) is a universal problem but its prevalence using recent reference growth charts and morbidities associated with it are lacking. The study aims at estimating EUGR prevalence in very low birth weight (VLBW) neonates and its associated morbidities. Methods: All VLBW neonates admitted to NICU between Jan 2018 to June 2019 were analysed. Neonatal anthropometries were recorded on Intergrowth 21st gender based postnatal growth chart. EUGR was defined by weight below 10th percentile at discharge. Demographic profile and neonatal morbidities were compared between EUGR and non-EUGR by using unpaired t test and Chi-square test. Regression was used for identification of the risk factors. Results: Out of 148 VLBW neonates, 92 (62.1%) were male, 26 (17.56%) were below 1000 gm, 102 (68%) were EUGR at discharge. Mean (SD) birth weight and gestational age were 1202 (221) gms and 30.89 (2.77) wks respectively. Caesarean delivery, higher gestational age, lower birth weight, SGA at birth and prolonged duration to achieve full enteral feeding were significantly associated with EUGR (P < 0.05). Sepsis was significantly associated with EUGR (36.28% vs. 17.4%; P 0.022). EUGR babies needed longer hospital duration (24.56% vs. 16.78%; P 0.005) with a higher mean PMA at discharge (38.07 wks vs. 35.11 wks; P < 0.001). In regression model SGA at birth and delay in achieving full feeding were independent predictor of EUGR. Conclusions: In VLBW neonate, prevalence of EUGR at discharge was 68%. Sepsis was significantly associated with EUGR. SGA and delay in achieving full feeding were independent predictors of EUGR.