One-year anthropometric follow-up of South African preterm infants in kangaroo mother care: Which early-life factors predict malnutrition?

Autor: Nel S; Department of Human Nutrition, University of Pretoria, Pretoria, South Africa.; Fetal, Newborn & Child Health Care Strategies, Kalafong Hospital, University of Pretoria Research Centre for Maternal, Atteridgeville, South Africa.; South African Medical Research Council (SA MRC) Maternal and Infant Health Care Strategies Unit, Kalafong Hospital, Atteridgeville, South Africa., Wenhold F; Department of Human Nutrition, University of Pretoria, Pretoria, South Africa.; Fetal, Newborn & Child Health Care Strategies, Kalafong Hospital, University of Pretoria Research Centre for Maternal, Atteridgeville, South Africa.; South African Medical Research Council (SA MRC) Maternal and Infant Health Care Strategies Unit, Kalafong Hospital, Atteridgeville, South Africa., Botha T; Fetal, Newborn & Child Health Care Strategies, Kalafong Hospital, University of Pretoria Research Centre for Maternal, Atteridgeville, South Africa.; South African Medical Research Council (SA MRC) Maternal and Infant Health Care Strategies Unit, Kalafong Hospital, Atteridgeville, South Africa.; Department of Statistics, University of Pretoria, Pretoria, South Africa., Feucht U; Fetal, Newborn & Child Health Care Strategies, Kalafong Hospital, University of Pretoria Research Centre for Maternal, Atteridgeville, South Africa.; South African Medical Research Council (SA MRC) Maternal and Infant Health Care Strategies Unit, Kalafong Hospital, Atteridgeville, South Africa.; Department of Paediatrics, University of Pretoria, Pretoria, South Africa.; Gauteng Department of Health, Tshwane District Health Services, Pretoria, South Africa.
Jazyk: angličtina
Zdroj: Tropical medicine & international health : TM & IH [Trop Med Int Health] 2024 Apr; Vol. 29 (4), pp. 292-302. Date of Electronic Publication: 2024 Feb 08.
DOI: 10.1111/tmi.13973
Abstrakt: Background: Preterm infants often have poor short- and long-term growth. Kangaroo mother care supports short-term growth, but longer-term outcomes are unclear.
Methods: This study analysed longitudinally collected routine clinical data from a South African cohort of preterm infants (born <37 weeks gestation) attending the outpatient follow-up clinic of a tertiary-level hospital (Tshwane District, South Africa) for 1 year between 2012 and 2019. At 1 year, small-for-gestational age (SGA) and appropriate-for-gestational age (AGA) infants were compared with regard to age-corrected anthropometric z-scores (weight-for-age [WAZ], length-for-age [LAZ], weight-for-length [WLZ] and BMI-for-age [BMIZ]) and rates of underweight (WAZ < -2), stunting (LAZ < -2), wasting (WLZ < -2) and overweight (BMIZ> + 2). Multiple regression analysis was used to investigate associations between maternal/infant characteristics and rates of underweight, stunting, wasting and overweight.
Results: At 1 year, compared with AGA infants (n = 210), SGA infants (n = 111) had lower WAZ (-1.26 ± 1.32 vs. -0.22 ± 1.24, p < 0.001), LAZ (-1.50 ± 1.11 vs. -0.60 ± 1.06, p < 0.001), WLZ (-0.66 ± 1.31 vs. 0.11 ± 1.24, p < 0.001) and BMIZ (-0.55 ± 1.31 vs. 1.06 ± 1.23, p < 0.001), despite larger WAZ gains from birth (+0.70 ± 1.30 vs. +0.05 ± 1.30, p < 0.001). SGA infants had significantly more stunting (34.2% vs. 9.1%; p < 0.001), underweight (31.2% vs. 7.2%; p < 0.001) and wasting (12.6% vs. 4.3%, p = 0.012), with no difference in overweight (4.5% vs. 7.7%, p = 0.397). In multiple regression analysis, birth weight-for-GA z-score more consistently predicted 1-year malnutrition than SGA.
Conclusion: Preterm-born SGA infants remain more underweight, stunted and wasted than their preterm-born AGA peers at 1 year, despite greater WAZ gains. Interventions for appropriate catch-up growth especially for SGA preterm infants are needed.
(© 2024 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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