Population-based study shows improved postnatal growth in preterm very-low-birthweight infants between 1995 and 2010

Abstract

Aim: To assess whether the postnatal growth of preterm very-low-birthweight (VLBW) infants, as determined by measures of postnatal growth failure (PNGF), improved during the period 1995-2010 and to evaluate postnatal growth by gestational age (GA) and intrauterine growth groups.

Methods: The study was based on the Israel national VLBW infant database and comprised 13 531 VLBW infants of 24-32 weeks' GA, discharged at a postmenstrual age of ≤40 weeks. Z-scores were determined for weight at birth and discharge. Severe and mild PNGF was defined as a decrease >2 and 1-2 z-scores, respectively. Three time periods were considered: 1995-2000, 2001-2005 and 2006-2010. Multinomial logistic regression was used to assess the independent effect of time period on PNGF.

Results: Severe PNGF decreased from 11.7% in 1995-2000 to 7.2% in 2001-2005 and 5.2% in 2006-2010. Infants born in 2006-2010 had sixfold lower odds for severe PNGF than babies born in 1995-2000 (adjusted odds ratio 0.17, 95% confidence interval 0.14-0.21) and <twofold lower odds for mild PNGF (adjusted odds ratio 0.42, 95% confidence interval 0.39-0.48).

Conclusion: We demonstrated a marked decline in PNGF among preterm VLBW infants from 1995-2000 to 2006-2010. This decline was even present in extremely premature infants.

Keywords: Extrauterine growth restriction; Extrauterine growth retardation; Postnatal growth failure; Preterm infants; Very low birthweight.