Extrauterine growth restriction: Universal problem among premature infants
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista de Nutrição |
Texto Completo: | https://periodicos.puc-campinas.edu.br/nutricao/article/view/7959 |
Resumo: | ObjectiveTo analyze the growth rate of premature infants in the first weeks of life and factors associated with extrauterine growth restriction. MethodsThis is a cross-sectional study of 254 premature infants in a neonatal intensive care unit conducted from January 1, 2008 to December 31, 2010. Infants who died or had malformations incompatible with life were excluded. Median weight curves according to gestational age were constructed for the first four weeks of life. The Fenton growth chart calculations provided the weight Z-scores. Extrauterine growth restriction was defined as corrected weight-for-age Z-score ≤-2. Perinatal, morbidity, and health care variables were analyzed. The Poisson regression model yielded the prevalence ratios. Associations between extrauterine growth restriction and the perinatal, morbidity, and care variables were investigated. Poisson regression controlled possibleconfounding factors. ResultsThe frequency of extrauterine growth restriction was 24.0%. Most (85.0%) small-for-gestational-age infants developed extrauterine growth restriction; 55.3% of extrauterine growth restriction cases involved small-forgestational-age infants. Premature infants with gestational age >32 weeks did not recover the median birth weight until the third week of life and had a higher frequency of small-for-gestational-age. The Z-scores ofnon-small-for-gestational-age infants decreased more after birth than those of small-for-gestational-age infants. extrauterine growth restriction was associated with small-for-gestational-age (PR=6.14; 95%CI=3.33-11.33;p<0.001) and time without enteral diet (PR=1.08; 95%CI=1.04-1.13; p=0.010). ConclusionExtrauterine growth restriction occurs in premature infants of all gestational age. The participation of small-forgestational-age and nutritional practices in its genesis is noteworthy. We suggest prospective studies of all premature infants. The implementation of best care practices, individualized for small-for-gestational-age infants, to improve nutrient supply can minimize the problem. |
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Extrauterine growth restriction: Universal problem among premature infantsRestrição de crescimento extrauterino: problema universal entre os prematurosGrowth and developmentInfant, prematureMalnutritionCrescimento e desenvolvimentoPrematurocDesnutriçãoObjectiveTo analyze the growth rate of premature infants in the first weeks of life and factors associated with extrauterine growth restriction. MethodsThis is a cross-sectional study of 254 premature infants in a neonatal intensive care unit conducted from January 1, 2008 to December 31, 2010. Infants who died or had malformations incompatible with life were excluded. Median weight curves according to gestational age were constructed for the first four weeks of life. The Fenton growth chart calculations provided the weight Z-scores. Extrauterine growth restriction was defined as corrected weight-for-age Z-score ≤-2. Perinatal, morbidity, and health care variables were analyzed. The Poisson regression model yielded the prevalence ratios. Associations between extrauterine growth restriction and the perinatal, morbidity, and care variables were investigated. Poisson regression controlled possibleconfounding factors. ResultsThe frequency of extrauterine growth restriction was 24.0%. Most (85.0%) small-for-gestational-age infants developed extrauterine growth restriction; 55.3% of extrauterine growth restriction cases involved small-forgestational-age infants. Premature infants with gestational age >32 weeks did not recover the median birth weight until the third week of life and had a higher frequency of small-for-gestational-age. The Z-scores ofnon-small-for-gestational-age infants decreased more after birth than those of small-for-gestational-age infants. extrauterine growth restriction was associated with small-for-gestational-age (PR=6.14; 95%CI=3.33-11.33;p<0.001) and time without enteral diet (PR=1.08; 95%CI=1.04-1.13; p=0.010). ConclusionExtrauterine growth restriction occurs in premature infants of all gestational age. The participation of small-forgestational-age and nutritional practices in its genesis is noteworthy. We suggest prospective studies of all premature infants. The implementation of best care practices, individualized for small-for-gestational-age infants, to improve nutrient supply can minimize the problem.ObjetivoAnalisar o crescimento de prematuros nas primeiras semanas de vida e fatores associados à restrição de crescimento extrauterino. MétodosEstudo transversal realizado entre 01/01/2008 e 31/12/2010 com 254 prematuros em unidade de terapia intensiva. Excluíram-se óbitos e malformações incompatíveis com a vida. Construíram-se curvas de medianas de peso para as quatro primeiras semanas de vida de acordo com a idade gestacional. Calcularam-se escores-Z do peso pela planilha Fenton growth chart calculations. Definiu-se restrição de crescimento extrauterino pelos escores-Z do peso ≤-2 para a idade corrigida na alta hospitalar. Analisaram-se associações entre variáveis perinatais, assistenciais e morbidades com a restrição de crescimento extrauterino. Utilizou-se a regressão de Poisson para controlar os possíveis fatores de confundimento. ResultadosA frequência de restrição de crescimento extrauterino foi de 24%. Dos pequenos para a idade gestacional, 85% evoluíram com restrição de crescimento extrauterino. Prematuros com idade gestacional >32 semanas não recuperaram medianas de peso ao nascer até a terceira semana de vida, e, dentre eles, estava a maior frequência de pequenos para a idade gestacional. Os não pequenos para a idade gestacional apresentaram maior queda do escore-Z de peso do nascimento à alta quando comparados aos pequenos para a idade gestacional. Associaram-se à restrição de crescimento extrauterino nascer pequeno para a idade gestacional (RP=6,14; IC95%=3,33-11,33; p<0,001) e tempo sem dieta enteral (RP=1,08; IC95%=1,04-1,13; p=0,010). ConclusãoA restrição de crescimento extrauterino ocorre entre prematuros de todas as idades gestacionais, ressaltando-se a participação do nascimento pequeno para a idade gestacional e das práticas nutricionais na sua gênese Sugerem-se estudos prospectivos que envolvam todos os prematuros. A implementação de boas práticas assistenciais que visem melhorar a oferta nutricional e individualizada para os pequenos para a idade gestacional pode minimizar o problema.Núcleo de Editoração – PUC-Campinas2023-03-21info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://periodicos.puc-campinas.edu.br/nutricao/article/view/7959Brazilian Journal of Nutrition; Vol. 29 No. 1 (2016): Revista de NutriçãoRevista de Nutrição; Vol. 29 Núm. 1 (2016): Revista de NutriçãoRevista de Nutrição; v. 29 n. 1 (2016): Revista de Nutrição1678-9865reponame:Revista de Nutriçãoinstname:Pontifícia Universidade Católica de Campinas (PUC-CAMPINAS)instacron:PUC_CAMPenghttps://periodicos.puc-campinas.edu.br/nutricao/article/view/7959/5476Copyright (c) 2023 Brunnella Alcantara Chagas de FREITAS, Silvia Eloiza PRIORE, Luciana Moreira LIMA, Sylvia do Carmo Castro FRANCESCHINIhttps://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessAlcantara Chagas de FREITAS, Brunnella PRIORE, Silvia Eloiza Moreira LIMA, Lucianado Carmo Castro FRANCESCHINI, Sylvia 2023-03-21T18:41:19Zoai:ojs.periodicos.puc-campinas.edu.br:article/7959Revistahttp://www.scielo.br/rnPRIhttps://periodicos.puc-campinas.edu.br/nutricao/oai||sbi.submissionrn@puc-campinas.edu.br1678-98651415-5273opendoar:2023-03-21T18:41:19Revista de Nutrição - Pontifícia Universidade Católica de Campinas (PUC-CAMPINAS)false |
dc.title.none.fl_str_mv |
Extrauterine growth restriction: Universal problem among premature infants Restrição de crescimento extrauterino: problema universal entre os prematuros |
title |
Extrauterine growth restriction: Universal problem among premature infants |
spellingShingle |
Extrauterine growth restriction: Universal problem among premature infants Alcantara Chagas de FREITAS, Brunnella Growth and development Infant, premature Malnutrition Crescimento e desenvolvimento Prematuroc Desnutrição |
title_short |
Extrauterine growth restriction: Universal problem among premature infants |
title_full |
Extrauterine growth restriction: Universal problem among premature infants |
title_fullStr |
Extrauterine growth restriction: Universal problem among premature infants |
title_full_unstemmed |
Extrauterine growth restriction: Universal problem among premature infants |
title_sort |
Extrauterine growth restriction: Universal problem among premature infants |
author |
Alcantara Chagas de FREITAS, Brunnella |
author_facet |
Alcantara Chagas de FREITAS, Brunnella PRIORE, Silvia Eloiza Moreira LIMA, Luciana do Carmo Castro FRANCESCHINI, Sylvia |
author_role |
author |
author2 |
PRIORE, Silvia Eloiza Moreira LIMA, Luciana do Carmo Castro FRANCESCHINI, Sylvia |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Alcantara Chagas de FREITAS, Brunnella PRIORE, Silvia Eloiza Moreira LIMA, Luciana do Carmo Castro FRANCESCHINI, Sylvia |
dc.subject.por.fl_str_mv |
Growth and development Infant, premature Malnutrition Crescimento e desenvolvimento Prematuroc Desnutrição |
topic |
Growth and development Infant, premature Malnutrition Crescimento e desenvolvimento Prematuroc Desnutrição |
description |
ObjectiveTo analyze the growth rate of premature infants in the first weeks of life and factors associated with extrauterine growth restriction. MethodsThis is a cross-sectional study of 254 premature infants in a neonatal intensive care unit conducted from January 1, 2008 to December 31, 2010. Infants who died or had malformations incompatible with life were excluded. Median weight curves according to gestational age were constructed for the first four weeks of life. The Fenton growth chart calculations provided the weight Z-scores. Extrauterine growth restriction was defined as corrected weight-for-age Z-score ≤-2. Perinatal, morbidity, and health care variables were analyzed. The Poisson regression model yielded the prevalence ratios. Associations between extrauterine growth restriction and the perinatal, morbidity, and care variables were investigated. Poisson regression controlled possibleconfounding factors. ResultsThe frequency of extrauterine growth restriction was 24.0%. Most (85.0%) small-for-gestational-age infants developed extrauterine growth restriction; 55.3% of extrauterine growth restriction cases involved small-forgestational-age infants. Premature infants with gestational age >32 weeks did not recover the median birth weight until the third week of life and had a higher frequency of small-for-gestational-age. The Z-scores ofnon-small-for-gestational-age infants decreased more after birth than those of small-for-gestational-age infants. extrauterine growth restriction was associated with small-for-gestational-age (PR=6.14; 95%CI=3.33-11.33;p<0.001) and time without enteral diet (PR=1.08; 95%CI=1.04-1.13; p=0.010). ConclusionExtrauterine growth restriction occurs in premature infants of all gestational age. The participation of small-forgestational-age and nutritional practices in its genesis is noteworthy. We suggest prospective studies of all premature infants. The implementation of best care practices, individualized for small-for-gestational-age infants, to improve nutrient supply can minimize the problem. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-03-21 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://periodicos.puc-campinas.edu.br/nutricao/article/view/7959 |
url |
https://periodicos.puc-campinas.edu.br/nutricao/article/view/7959 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://periodicos.puc-campinas.edu.br/nutricao/article/view/7959/5476 |
dc.rights.driver.fl_str_mv |
https://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
https://creativecommons.org/licenses/by/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Núcleo de Editoração – PUC-Campinas |
publisher.none.fl_str_mv |
Núcleo de Editoração – PUC-Campinas |
dc.source.none.fl_str_mv |
Brazilian Journal of Nutrition; Vol. 29 No. 1 (2016): Revista de Nutrição Revista de Nutrição; Vol. 29 Núm. 1 (2016): Revista de Nutrição Revista de Nutrição; v. 29 n. 1 (2016): Revista de Nutrição 1678-9865 reponame:Revista de Nutrição instname:Pontifícia Universidade Católica de Campinas (PUC-CAMPINAS) instacron:PUC_CAMP |
instname_str |
Pontifícia Universidade Católica de Campinas (PUC-CAMPINAS) |
instacron_str |
PUC_CAMP |
institution |
PUC_CAMP |
reponame_str |
Revista de Nutrição |
collection |
Revista de Nutrição |
repository.name.fl_str_mv |
Revista de Nutrição - Pontifícia Universidade Católica de Campinas (PUC-CAMPINAS) |
repository.mail.fl_str_mv |
||sbi.submissionrn@puc-campinas.edu.br |
_version_ |
1799126068472315904 |