Growth and Nutritional Status at Corrected Term Gestational Age in Very Low Birth Weight Infants

Abstract

Objective To evaluate the growth and nutritional status at term (39–41 weeks) corrected gestational age in VLBW infants and to study the predictors of malnutrition. Methods This Cross-sectional study was conducted in a tertiary care perinatal centre with level III NICU. All Inborn VLBW infants who were discharged alive from the hospital during the study period from January 2008 through June 2009 were included in this study. Relevant perinatal, clinical and anthropometry data were collected at birth, at hospital discharge and at term gestation. Primary outcome was considered as Z scores of weight, occipitofrontal circumference, length and predictors of postnatal malnutrition (z-score for weight ≤2SD) at term gestation. Results The mean gestational age and the mean birth weight of study subjects were 31.03 ± 2.18 weeks and 1195.28 ± 191.25 g respectively. Twenty-six (15%) infants had birth weight less than 1,000 g and 65 (37.4%) infants were of gestation less than 31 weeks. The mean weight, the mean length and mean occipitofrontal circumference (OFC) at term gestation were 2367.32 ± 521 g, 43.72 ± 3.3 cm and 32.65 ± 1.6 cm respectively. The mean z scores for weight, length and OFC at term gestation was −1.66 ± 1.2, −1.98 ± 1.3 and −0.48 ± 0.7 respectively. Forty three percent (n = 75) infants were malnourished. Birth weight (p = 0.005), gestational age (p = 0.001), z-score at birth (p = 0.001), female sex (p = 0.004), duration of oxygen (p = 0.008), duration of hospitalization (p = 0.005) and average post discharge weight gain per day (p < 0.001) predicted malnutrition. Conclusions There is a high prevalence of postnatal malnutrition in VLBW infants. Poor intrauterine growth, female sex, lower birth weight, lower gestation, infant sickness and poor post-discharge weight gain contribute significantly to postnatal malnutrition