Growth during early postnatal life may have longterm consequences for health and development of preterm infants. Little information is available on the influence of clinical characteristics and practices upon growth in VLBW(<1500g) infants. We analyzed prospectively collected data from 1719 VLBW infants admitted to 7 regional NICUs from Oct 94-June 96. Body weight was recorded on days 1, 3, 14, and 28 and head circumference (HC) on days 1 and 28. Illness severity was measured using the Score for Neonatal Acute Physiology (SNAP). Anomalous infants, nonsurvivors and those with necrotizing enterocolitis or sepsis were excluded from analysis. We determined that in the first postnatal month, BW and SGA were the principal predictors of somatic growth for infants with BW <1000g. For larger VLBWs (1000-1500g), illness severity, gender and race also significantly influenced weight gain and HC growth. Applying linear regression to all infants to adjust for these factors, highly significant growth differences persisted among sites:Table Site F showed significantly greater weight-adjusted growth in each VLBW quartile (BW: <750, 750-999, 1000-1249, 1250-1500g). Decreased growth at site C was significant for <750g infants; at site G, lesser growth occurred principally for >1000g infants. These findings suggest that, despite case mix adjustments, NICUs perform differently in terms of growth. Differential growth for VLBWs may reflect variations in nutritional practices and/or management of energy expenditures.

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