First-year growth patterns of preterm infants receiving kangaroo mother care: associations with early life factors and 1-year anthropometry.

IF 3.3 3区医学 Q2 NUTRITION & DIETETICS

European Journal of Clinical Nutrition Pub Date : 2025-10-15 DOI:10.1038/s41430-025-01662-6

S Nel, U D Feucht, T Botha, M Arashi, F A M Wenhold

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引用次数: 0

Abstract

Background: This study characterises first-year growth patterns in a historical preterm infant cohort, and investigates associated early-life factors and 1-year anthropometry.

Methods: We analysed 322 South African preterm infants' (mean 32.8 ± 2.4 weeks gestation) 1-year clinic records after kangaroo mother care discharge. Latent class trajectory modelling identified patterns of weight-for-age (WAZ), length-for-age (LAZ), weight-for-length (WLZ), and head circumference-for-age (HCZ) z-scores (Fenton 2013 Growth Chart; WHO Growth Standards, age-corrected). Z-score patterns were characterised as maintenance, faltering (progressively decreasing), gain (progressively increasing) or catch-up (rapidly increasing, exceeding birth z-score). Ordinal regression analysis investigated associations of early-life maternal/infant factors, birth weight, and early (until 50 weeks postmenstrual age) WAZ gain with growth patterns. One-year stunting (LAZ < -2), wasting (WLZ < -2) and overweight (body mass index-for-age z-score > +2) were compared.

Results: Best-fit models identified three WAZ and LAZ patterns (gradual gain, faltering, catch-up), three WLZ patterns (maintenance, faltering, catch-up) and two HCZ patterns (maintenance, gain). Most infants displayed maintenance, gradual gain or catch-up. Lower birth weight z-score (BWZ) was associated with LAZ catch-up (OR:8.33 (3.13-20.00)), WLZ faltering (OR:2.94 (1.69-5.00)) HCZ gain (OR:1.92 (1.23-3.13)), but lower odds of gradual WAZ gain (OR:0.36 (0.19-0.68)) and WAZ faltering (OR:0.56 (0.34-0.92)). Smaller early WAZ gains were associated with gradual WAZ gain (OR:2.27 (1.56-3.33)), WAZ faltering (OR:1.47 (1.11,1.96)), LAZ catch-up (OR:1.85 (1.25-2.70)), and LAZ faltering (OR:1.39 (1.09-1.75)). WAZ and WLZ faltering were both associated (p < 0.001) with 1-year stunting (45.5%, 23.5%) and wasting (21.8%, 10.3%).

Conclusions: Most preterm infants had appropriate first-year growth. Lower BWZ was associated with WAZ and LAZ catch-up but WLZ faltering, and sub-optimal early WAZ growth with growth faltering.

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接受袋鼠妈妈护理的早产儿第一年的生长模式：与早期生活因素和一岁人体测量的关系。

背景：本研究分析了历史早产儿队列中第一年的生长模式，并调查了相关的早期生活因素和一岁人体测量。方法：对322例南非早产儿（平均妊娠32.8±2.4周）在袋鼠妈妈护理出院后1年的临床记录进行分析。潜在类别轨迹模型确定了年龄比体重（WAZ）、年龄比身高（LAZ）、身高比体重（WLZ）和年龄比头围（HCZ） z分数的模式（Fenton 2013年生长图；WHO生长标准，年龄校正）。Z-score模式的特征是维持、蹒跚（逐渐减少）、获得（逐渐增加）或追赶（迅速增加，超过出生Z-score）。序数回归分析调查了早期母婴因素、出生体重和早期（月经后50周）WAZ增加与生长模式的关系。1年发育迟缓率（LAZ +2）比较。结果：最佳拟合模型确定了三种WAZ和LAZ模式（逐渐增加、衰退、追赶），三种WLZ模式（维持、衰退、追赶）和两种HCZ模式（维持、增长）。大多数婴儿表现为维持、逐渐增加或追赶。较低的出生体重z-score （BWZ）与LAZ追赶（OR:8.33(3.13-20.00)）、WLZ蹒跚（OR:2.94(1.69-5.00)）、HCZ增加（OR:1.92(1.23-3.13)）相关，但WAZ逐渐增加（OR:0.36(0.19-0.68)）和WAZ蹒跚（OR:0.56(0.34-0.92)）的几率较低。较小的早期WAZ增益与逐渐的WAZ增益（OR:2.27(1.56-3.33)）、WAZ衰减（OR:1.47(1.11,1.96)）、LAZ追赶（OR:1.85(1.25-2.70)）和LAZ衰减（OR:1.39(1.09-1.75)）相关。WAZ和WLZ蹒跚均相关(p结论：大多数早产儿一岁生长正常。低BWZ与WAZ和LAZ的追赶相关，但与WLZ的衰退相关，与次优早期WAZ生长相关，但与生长衰退相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Clinical Nutrition 医学-营养学

CiteScore

10.60

自引率

2.10%

发文量

189

审稿时长

3-6 weeks

期刊介绍： The European Journal of Clinical Nutrition (EJCN) is an international, peer-reviewed journal covering all aspects of human and clinical nutrition. The journal welcomes original research, reviews, case reports and brief communications based on clinical, metabolic and epidemiological studies that describe methodologies, mechanisms, associations and benefits of nutritional interventions for clinical disease and health promotion. Topics of interest include but are not limited to: Nutrition and Health (including climate and ecological aspects) Metabolism & Metabolomics Genomics and personalized strategies in nutrition Nutrition during the early life cycle Health issues and nutrition in the elderly Phenotyping in clinical nutrition Nutrition in acute and chronic diseases The double burden of ''malnutrition'': Under-nutrition and Obesity Prevention of Non Communicable Diseases (NCD)