Growth of extremely low birth weight infants at a tertiary hospital in a middle- income country
Date
2020
Authors
Mabhandi, Tendai
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Abstract
Background: Survival of extremely low birth weight (ELBW; birth weight less than 1000 g) infants has improved
significantly since the 1990s. Consequently, growth monitoring in ELBW infants has gained more relevance.
Methods: We conducted this study to describe the growth of ELBW infants at a tertiary hospital, to audit macronutrient
intake and explore the association of prematurity complications with growth. This was a retrospective study on 92 ELBW
infants born at Charlotte Maxeke Johannesburg Academic Hospital. The association between good growth (regaining
birth weight in 21 days or less and subsequent growth velocity > 15 g/kg/day) and complications of prematurity
was explored.
Results: Only 11infants (13%) had a discharge weight above the 10th centile when the Fenton growth chart was
used compared to 20 infants (22.4%) when the Intergrowth 21st Project growth standard was used. The mean
weight velocity was 13.5 g/kg/day and the mean number of days to regain birth weight was 18.2 days. Factors
associated with poor growth were late-onset sepsis, persistent patent ductus arteriosus, continuous positive
airway pressure for more than 2 days, invasive ventilation, oxygen on day 28 and being kept nil per os. Protein
and caloric intake correlate positively with growth velocity. Unlike the Fenton Growth Charts, use of the
Intergrowth 21st Project growth standards revealed the association between neonatal factors and poor growth.
Conclusion: Growth outcome in infants is poor at 36 weeks postmenstrual age at our institution. Intergrowth
21st Project growth standards were superior to Fenton Growth Charts, however a multicentre study is required
before adoption.
Description
A research report submitted in partial fulfilment of the requirements for the degree of Master of Medicine in Paediatrics to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2020