Intersite Differences in Weight Growth Velocity of Extremely Premature Infants
- 1 December 2002
- journal article
- Published by American Academy of Pediatrics (AAP) in Pediatrics
- Vol. 110 (6), 1125-1132
- https://doi.org/10.1542/peds.110.6.1125
Abstract
Objective. To explain differences in weight growth velocity of extremely premature infants among 6 level III neonatal intensive care units (NICUs). Methods. In 6 NICUs, we studied 564 infants, stratified by gestational age (GA), who were first admissions, survivors, Results. Weight growth velocities varied significantly among the 6 NICUs. Adjustment for case mix and medical factors explained little of this variability, but additional control for calorie and especially protein intake accounted for much of the intersite variability. For the average infant, adjusted growth velocity ranged from 10.4 to 14.3 g/kg/d among the sites studied. The final predictive model, including case mix and medical and nutritional factors, explained 53% of the overall variance in growth velocity. Prolonged (≥15 days) exposure to postnatal steroids and greater severity of illness both decreased growth velocity. The model predicted that adding 1 g/kg/d protein to the mean intake for our sample would increase growth by 4.1 g/kg/d. Conclusions. Variation in nutrition explained much of the difference in growth among the NICUs studied. Mean intake of calories and protein failed to meet recommended levels, and the average growth in only 1 NICU approximated intrauterine growth standards. Increasing nutritional intake into the recommended ranges, in particular of protein, may increase growth of extremely premature infants up to or above intrauterine rates.Keywords
This publication has 31 references indexed in Scilit:
- Postnatal Malnutrition and Growth Retardation: An Inevitable Consequence of Current Recommendations in Preterm Infants?Pediatrics, 2001
- Very Low Birth Weight Outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, January 1995 Through December 1996Pediatrics, 2001
- Collaborative Quality Improvement for Neonatal Intensive CarePediatrics, 2001
- Growth of Very Premature Infants Fed Intravenous Hyperalimentation and Calcium-supplemented FormulaPediatrics, 1997
- Effect of dexamethasone on protein metabolism in infants with bronchopulmonary dysplasiaThe Journal of Pediatrics, 1994
- Dexamethasone therapy for chronic lung disease in ventilator- and oxygen-dependent infants: A controlled trialThe Journal of Pediatrics, 1989
- Catch-up growth, muscle and fat accretion, and body proportionality of infants one year after newborn intensive careThe Journal of Pediatrics, 1989
- Physical growth and developmental outcome in very low birth weight premature infants at 3 years of ageThe Journal of Pediatrics, 1985
- Neonatal Necrotizing EnterocolitisAnnals of Surgery, 1978
- Intrauterine growth of live-born Caucasian infants at sea level: Standards obtained from measurements in 7 dimensions of infants born between 25 and 44 weeksThe Journal of Pediatrics, 1969