Angela B Hoyos, Pablo Vásquez-Hoyos, Carlos A Fajardo, Horacio Osiovich, Martha Baez, Carolina Villegas Álvarez
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引用次数: 0
Abstract
Background: Postnatal weight loss is nearly universal in preterm infants, and its relationship to head circumference (HC) growth remains incompletely characterized. Growth standards were recently updated with the Fenton 2025 charts, which modify Z-score parameters compared to the 2013 version.
Objective: To evaluate the association between postnatal weight trajectory and HC growth from birth to discharge in preterm infants ≤32 weeks of gestation across a large multicenter Latin American cohort, using Fenton 2025 growth standards.
Methods: This observational cohort study by secondary analysis of a prospective cohort study using data from EpicLatino, a quality improvement registry of 35 neonatal intensive care units (NICUs) across Latin America and the Caribbean (2015-2024). Infants ≤32 weeks admitted within 48 h of birth were included. The exposure was the change in weight Z-score (Fenton 2025) from birth to discharge, categorized into 10 groups at 0.4-unit intervals. The primary outcome was the change in HC Z-score (Fenton 2025). Multivariable linear regression with average marginal predictions was used, adjusting for gestational age, necrotizing enterocolitis (NEC), sepsis, SNAP-II score, length of stay, treated patent ductus arteriosus, Apgar score at 5 min, HC Z-score at birth, and outborn status.
Results: 3926 infants were included (analytical sample n = 3757). Median gestational age was 30 [IQR 29-32] weeks. Adjusted HC Δ Z-score ranged from -0.34 (95% CI -0.38 to -0.30) in infants with weight Δ Z-score >0, to -2.71 (95% CI -2.83 to -2.58) in those with weight Δ Z-score ≤-3.2. All group comparisons were statistically significant (p < 0.001). The model explained 37.6% of the variance in HC growth.
Conclusions: Postnatal weight trajectory is independently and progressively associated with HC growth in preterm infants ≤32 weeks across Latin America. Supporting weight recovery toward birth Z-score is a key nutritional target to promote adequate HC growth in the NICU.
期刊介绍：
The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development.
The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.
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