Postnatal weight gain of premature small for gestational age versus appropriate for gestational age infants during NICU stay.

Abstract

To assess the feeding characteristics and postnatal weight gain of premature small for gestational age (SGA) versus appropriate for gestational age (AGA) infants during neonatal intensive care unit stay and to investigate the association between postnatal growth failure (PGF) and neonatal variables. This retrospective study was conducted on premature infants with a birth weight ≤1500 g and a gestational age <32 weeks, born between January 2013 and June 2016. The infants were categorized into two groups: SGA (n = 42) and AGA (n = 380). The groups were compared in terms of demographics, clinical characteristics, and PGF at discharge. PGF was defined as a decrease in the z-score of more than 1.34 from birth to discharge. Multiple logistic regression analysis was used to identify variables associated with PGF. SGA infants had a longer time to achieve full enteral feeding (P = .010) and a longer duration of total parenteral nutrition (P = .001). Although the frequency of feeding intolerance was higher in SGA infants, the difference was not statistically significant (P = .056). The overall prevalence of PGF at discharge was 42% and comparable between the two groups. Late-onset sepsis, hemodynamically significant patent ductus arteriosus and lower weight z-score at fourth week of life [adjusted odds ratio (aOR) = 1.69, 95% confidence interval (CI) = 1.06-2.69, P = .027; aOR = 1.75, 95% CI = 1.14-2.68, P = .01; and aOR = 1.86, 95% CI = 1.21-2.86, P = .004, respectively) were independently associated with an increased risk of PGF. SGA infants experienced more severe growth failure at discharge compared to AGA infants. However, the rate of PGF was similar between the two groups.