Growth of premature neonates admitted in a level III neonatal unit

Problem considered: The gold standard for postnatal growth for preterm neonates is their intrauterine growth standard. Extra uterine growth restriction (EUGR) implies weight less than minus 2 Z scores at discharge. 1 Methods: A prospective observational study of preterm neonates admitted at the level III neonatal unit of a tertiary care teaching hospital. Growth parameters (weight, length and head circumference) were recorded on admission, during hospitalization, at discharge and at term gestation. Z scores were calculated using Fenton's growth charts. 13,14 Growth velocity was calculated for weight, length and head circumference (HC). Results: The incidence of EUGR was 64.8% at discharge and 76.8% at term. Mean Z scores for weight, length and head circumference in neonates with EUGR and without EUGR were -1.36 0.80 vs -0.40 0.63 (p = 0.000), -1.21 1.27 vs -0.38 0.90 (p = 0.000), -1.35 1.04 vs -0.44 1.02 (p = 0.000) respectively at birth, -2.84 0.60 vs -1.38 0.79 (p - 0.000), -1.92 1.26 vs -0.85 0.88 (p - 0.000), &-1.85 1.10 vs -0.88 1.11 (p - 0.000) respectively at discharge & -2.84 1.18 vs - 2.44 1.16 (p = 0.102), 2.44 1.33 vs 1.95 1.29 (p = 0.071) & - 2.03 1.14 vs - 1.28 1.61 (p = 0.005) respectively at term. Mean growth velocities for neonates with EUGR and without EUGR were 7.98 4.63 vs 10.85 5.53 g/kg/day (p = 0.120) for weight, 0.65 0.24 vs 0.72 0.37 cm/week (p = 0.924) for length and 0.43 0.14 vs 0.41 0.15 cm/week (p = 0.439) for head circumference at discharge and 12.99 8.54 vs 12.70 7.58 g/kg/day (p - 0.924), 0.72 0.35 vs 0.62 0.22 cm/ week (p 0.145) and 0.49 0.16 vs 0.43 0.14 cm/week (p = 0.048) respectively for weight, length and head circumference at term. Conclusion: About two third premature neonates at discharge and three fourths at term had EUGR. Growth velocity for HC was significantly more in neonates with EUGR by term gestation indicating a brain sparing effect. Copyright 2014, INDIACLEN. Publishing Services by Reed Elsevier India Pvt Ltd. All rights reserved.