A Survey of Postnatal Under-nutrition in Very Low Birth Weight Infants

Objectives: To delineate the clinical manifestations and associated factors of postnatal growth failure in very low-birth-weight (VLBW) infants. Methods: A prospective study was conducted between July and December, 2004 at Chang Gung Children's Hospital. The proportion of small for gestational age (SGA) babies at birth and postnatal growth failure at term and 6 months old were determined. The clinical and biochemical differences between those who weighed ≧2800gm and ＜2800gm at the corrected age of term were compared. Using statistical analysis, we explored the factors associated with postnatal growth failure. Results: Of the 52 VLBW infants, 7.7% were SGA. These babies were followed up to term age and 6 months old, and 32.6% and 36.5%, respectively, had growth retardation. Babies who weighed ＜2800gm at term had lower anthropometric indices at 6 months than those who weighed ≥2800gm. In addition, they had longer periods of total parental nutrition and longer hospital stays. Using stepwise multiple logistic regression analysis, lower phosphorus/alkaline phosphatase (P/ALP) ratios and prolonged hospital stays were the two important factors associated with lower BW at a corrected age of term and 6 months old. Conclusions: Approximately one third of VLBW infants experienced growth failure at term and 6 months corrected age. This was particularly true in extremely low birth weight infants. Those who weighed ＜2800gm at term tended to have persistently poorer growth at the corrected age of 6 months. A lower P/ALP ratio and prolonged hospital stays were predictors for growth failure at term and 6 months corrected age.