Back to Journals » International Journal of General Medicine » Volume 13

Clinical and Nutritional Determinants of Extrauterine Growth Restriction Among Very Low Birth Weight Infants

Authors Khasawneh W, Khassawneh M, Mazin M, Al-Theiabat M, Alquraan T

Received 1 October 2020

Accepted for publication 28 October 2020

Published 19 November 2020 Volume 2020:13 Pages 1193—1200

DOI https://doi.org/10.2147/IJGM.S284943

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser


Wasim Khasawneh, Mohammad Khassawneh, Mai Mazin, Muath Al-Theiabat, Tuka Alquraan

Department of Pediatrics and Neonatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan

Correspondence: Wasim Khasawneh
Department of Pediatrics and Neonatology, Jordan University of Science and Technology, PO Box 3030, Irbid 22110, Jordan
Tel +962 796041117
Fax +962 27095777
Email wakhasawneh@just.edu.jo

Purpose: To identify the clinical and nutritional factors associated with extrauterine growth restriction (EUGR) among very low birth weight infants (VLBW) in a tertiary hospital in Jordan.
Patients and Methods: We conducted a retrospective analysis of all VLBW infants admitted at King Abdullah University Hospital between July 2015 and June 2020. Clinical factors, nutritional intake, and growth parameters were collected and analyzed. A multilogistic regression model was applied to identify factors associated with EUGR.
Results: Of the 247 VLBW infants included in analysis, 112 (45%) were males, 30 (12%) were below 1000 g, and 72 (29%) were small for gestational age (SGA). EUGR was diagnosed in 198 (80%) at discharge. The rates of EUGR among SGA and non-SGA infants were 97% and 73%, respectively. The EUGR infants had a higher gestational age (30.7 vs 29.8 weeks, p= 0.04), a lower birth weight (1209 vs 1300 g, p= 0.005), a longer ventilatory support (5.7 vs 2.2 days, p= 0.03), a higher incidence of sepsis (23% vs 10%, p= 0.05), and a longer hospitalization (46 vs 38 days, p= 0.03). With multilogistic regression model, the factors associated with EUGR include small-for-gestational age (AOR 9, 95% C.I. 2, 50), > 3-day delay in feeding initiation (AOR 3.8, 95% C.I. 1.2,10), > 14-day delay in achieving full feeds (AOR 3.3, 95% C.I. 1.2, 8), < 3 g/kg of protein intake on the 8th day (AOR 2.1, 95% C.I. 1.1, 4.1), < 100 kcal/kg of total caloric intake on the 15th day (AOR 3.8, 95% C.I. 1.6, 8.9), and occurrence of sepsis (AOR 3, 95% C.I. 1.1, 9).
Conclusion: The rate of EUGR in our unit is high. In addition to being SGA at birth, sepsis and suboptimal protein and caloric intake in the first two weeks of life were significantly associated with this complication. A more aggressive enteral and parenteral nutritional approach is needed to minimize postnatal growth delay.

Keywords: neonatal nutrition, EUGR, Jordan, VLBW infants

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]