Abstract
Background: Postnatal growth of very preterm neonates should approximate that of a normal fetus of the same postconceptional age. Extrauterine Growth Restriction (EUGR) is a major clinical problem especially in critically ill preterm neonates.
Objective: to study growth of very preterm newborns (less than 33 weeks gestational age) during hospital stay and determine risk factors of postnatal growth restriction.
Design/Methods: Every livebirths born before 33 weeks of GA in 1997 in 9 French areas (covering one third of French births) were prospectively included in the EPIPAGE study. Data are from one area (Nord-pas-de-Calais). From the appropriate for gestational age (AGA) population, EUGR was defined by weight at hospital discharge less than 2 standard deviations (Usher and Mc Lean). Birthweight was studied by class of 500g. Z score was assessed at day 14, at day 28, at hospital discharge. Risk factors for EUGR were studied by logistic regression.
Results: 486 newborns were AGA at birth. Rate of EUGR was 25% with a mean z score of −1.25(+/− 0.37) at day 28 and −0.67(+/−0.49) at hospital discharge. Factors independently associated with EUGR were: low class of birthweight (OR 5.3 [2.8–10.0]), respiratory distress syndrom (OR 1.7 [1.0–3.1]), necrotizing enterocolitis (OR 4.1 [1.4–11.9]), parenteral nutrition for more than ten days (OR 2.7 [1.3–5.8]) and hypertension during pregnancy (OR 1.9 [1.1–3.7]). High gestational age and no oxygen at day 28 reduced risk (OR 0.4[0.2–0.7] and OR 0.5[0.2–0.8] respectively).
Conclusions: EUGR rate was high in AGA very preterm newborns. Pregnancy hypertension appeared as a risk factor. Neonatal disease and nutritional status as well. This could lead to identify population at risk of EUGR for further prevention and follow-up.
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Desnoulez, L., Truffert, P., Putet, G. et al. 70 Risk Factors of Extrauterine Growth Restriction of Very Preterm Newborns. Results from The Epipage Nord Pas De Calais Cohort. Pediatr Res 56, 476 (2004). https://doi.org/10.1203/00006450-200409000-00093
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DOI: https://doi.org/10.1203/00006450-200409000-00093
