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Multicenter Study
. 2025 Aug 11:15:04168.
doi: 10.7189/jogh.15.04168.

An investigation into the impact of family integrated care on extrauterine growth restriction at discharge in very low birth weight infants: a multi-centre study

Meng-Fan Qiu #  1   2   3 , Yi Zhang #  4 , Ying-Zi Tang #  5 , Ya-Lan Dou  6 , Yuan Wang  2   3 , Tian-Chan Lyu  2 , Qiao-Ling Fan  7 , Yue-Lan Ma  8 , Fang Li  9 , Hui Rong  9 , Yun-Fei Tang  10 , Wei-Wei Gu  11 , Xiao-Chun Chen  12 , Dan Liu  13 , Hua Wang  13 , Juan Xiao  14 , Li-Li Zhang  14 , Yan Wang  15 , Ru-Ming Ye  1 , Dan Li  1 , Xiao-Xia Li  16 , Yu Pang  17 , Mei Lin  18 , Mei Lin  19 , Yan Xuan  20 , Xiao-Jing Hu  21   22 ; Research Group of Developmental Care for Very Low Birth Weight Infants in China
Affiliations
Multicenter Study

An investigation into the impact of family integrated care on extrauterine growth restriction at discharge in very low birth weight infants: a multi-centre study

Meng-Fan Qiu et al. J Glob Health. .

Abstract

Background: Family integrated care (FIC) encourages parental involvement in neonatal intensive care units (NICU) and has been found to promote weight gain in preterm infants. Extrauterine growth restriction (EUGR) results from inadequate growth among very low birth weight infants (VLBWI), which has been found to contribute to parental anxiety. To address an existing gap in research, we aimed to examine the impact of parental involvement on EUGR at discharge in VLBWI.

Methods: We conducted a retrospective, multi-centre case-control study involving VLBWIs admitted to 17 NICUs across eight southeastern Chinese provinces and cities from February 2021 to November 2023. We categorised cases and control groups based on the presence of EUGR at discharge and compared their perinatal and hospitalisation characteristics, as well as FIC duration, using a generalised linear mixed model.

Results: EUGR in VLBWI at discharge was associated with birth weight (odds ratio (OR) = 0.547; 95% confidence interval (CI) = 0.490, 0.610), gestational week (<28 weeks) (OR = 3.101; 95% CI = 1.909, 5.038), Apgar score at 1 minute ≤7 (OR = 1.525; 95% CI = 1.119, 2.079), being small for gestational age (OR = 3.269; 95% CI = 1.547, 6.908), maternal gestational hypertension (OR = 1.868; 95% CI = 1.270, 2.748), necrotising enterocolitis (OR = 2.254; 95% CI = 1.386, 3.667), and total FIC duration. Based on literature and clinical practice, we divided the total FIC duration into three groups. We found that the lowest OR was associated with >18 hours of care, followed by ≤18 hours, while the highest was associated with 0 hours of care.

Conclusions: We identified higher birth weight and FIC as protective factors against EUGR at discharge in VLBWI. In contrast, we recognised gestational age <28 weeks, an Apgar score ≤7 at 1 minute, small for gestational age, maternal gestational hypertension, and necrotising enterocolitis as risk factors. Nevertheless, further research is required to analyse the relationship between FIC and EUGR at discharge.

Registration: ClinicalTrials.gov (NCT06550440).

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Conflict of interest statement

Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests.

Figures

Figure 1
Figure 1
Flowchart for study population selection. EUGR – extrauterine growth restriction, FIC – family integrated care, NICU – neonatal intensive care unit, VLBWI – very low birth weight infants.
Figure 2
Figure 2
Number of study population in case and control groups by province (city).
Figure 3
Figure 3
Factors influencing extrauterine growth restriction in very low birth weight infants at discharge. CI – confidence interval, FIC – family integrated care, OR – odds ratio.
See this image and copyright information in PMC

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References

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