Postnatal growth of etiologically characterized preterm newborns according to gestational age at birth.

Autor: Roggero P; Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy., Ryumina I; Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, UK., Gunier RB; Center for Environmental Research and Community Health, School of Public Health, University of California, Berkeley, CA, USA., Winsey A; Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK., Rauch SA; Center for Environmental Research and Community Health, School of Public Health, University of California, Berkeley, CA, USA., Zarco IAC; Instituto Nacional de Perinatología 'Isidro Espinosa de los Reyes', Mexico City, Mexico., Ariff S; Division of Woman & Child Health, Dept of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan., Rego MAS; Department of Pediatrics, Federal University of Minas Gerais, Belo Horizonte, Brazil., Conti CS; Division Neonatología, Hospital Materno Infantil Ramón Sarda, Buenos Aires, Argentina., Ochieng R; The Aga Khan Hospital, Nairobi, Kenya., Tuzun F; Department of Pediatrics, Division of Neonatology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey., Asibey J; Holy Family Hospital, Brong Ahafo Region, Techiman, Ghana., Giuliani F; Azienda Ospedaliera OIRM Sant'Anna Citta della Salute e della Scienza di Torino, Torino, Italy., Renau MI; Neonatology Unit, Hospital Sant Joan de Deú, Barcelona, Spain., Shekharappa CB; Neonatology Department, St. John's Medical College Hospital, Bangalore, India., Lapillonne A; Dept of Neonatology, Hôpital Necker-Enfants Malades, Paris, France., Tavcioska G; General Hospital with Extended Activity Prilep, Trajko Tarcan' bbPrilep, Prilep, Republic of North Macedonia., Ismail LC; Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, UAE., Menis C; Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy., Markelova M; Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation., Nieto R; Division Neonatología, Hospital Materno Infantil Ramón Sarda, Buenos Aires, Argentina., Duah JA; Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK., Deantoni S; Neonatal Intensive Care Unit of the University of Turin, Turin, Italy., Madrid BF; Instituto Nacional de Perinatología 'Isidro Espinosa de los Reyes', Mexico City, Mexico., Mosca F; Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy., Eskenazi B; Center for Environmental Research and Community Health, School of Public Health, University of California, Berkeley, CA, USA., Lambert A; Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK., Bhutta Z; Center for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada., Papageorghiou A; Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, UK. aris.papageorghiou@wrh.ox.ac.uk.; Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK. aris.papageorghiou@wrh.ox.ac.uk., Kennedy S; Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, UK.; Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK., Villar J; Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, UK.; Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK.
Jazyk: angličtina
Zdroj: Pediatric research [Pediatr Res] 2024 Nov 28. Date of Electronic Publication: 2024 Nov 28.
DOI: 10.1038/s41390-024-03735-x
Abstrakt: Objective: To examine the relationship between etiologically-based preterm birth sub-groups and early postnatal growth according to gestational age at birth.
Methods: Prospective, multinational, cohort study involving 15 hospitals that monitored preterm newborns to hospital discharge. Measures/exposures: maternal demographics; etiologically-based preterm birth sub-groups; very, moderate and late preterm categories, and feeding.
Primary Outcomes: serial anthropometric measures expressed as z-scores of the INTERGROWTH-21 st preterm postnatal growth standards.
Results: We included 2320 singletons and 1180 twins: very=24.4% (n = 856, including 178 < 28 weeks' gestation); moderate=16.9% (n = 592) and late preterm=58.6% (n = 2052). The median (interquartile range) postmenstrual age at the last measure was 37 (36-38) weeks. The 'no main condition' sub-group percentage increased from early to late preterm; the 'perinatal sepsis' sub-group percentage decreased. 'Perinatal sepsis', 'suspected IUGR' and 'fetal distress' very and late preterm infants had lower postnatal growth patterns than the 'no main condition' reference sub-group. This pattern persisted in late but not very preterm infants when postnatal growth was corrected for weight z-score at birth.
Conclusion: The proportional contribution of etiologically-based preterm sub-groups and their postnatal growth trajectories vary by preterm category. Postnatal growth is partially independent of fetal growth in the majority of preterm infants (i.e., those born late preterm).
Impact: Preterm birth, the leading cause of under-5 mortality, is a highly heterogenous syndrome, with surviving infants at risk of suboptimal growth, morbidity, and impaired neurodevelopment. Both the proportional contribution of etiologically-based sub-groups and their postnatal growth trajectories vary by preterm category (very/moderate/late). The 'perinatal sepsis', 'suspected IUGR' and 'fetal distress' sub-groups amongst very and late preterm infants had lower postnatal growth than the 'no main condition' preterm infants. The pattern persisted after adjusting for birth size only in the late preterms. Postnatal growth is partially independent of fetal growth in the majority of preterm infants (i.e., those born late preterm).
Competing Interests: Competing interests: ATP is supported by the Oxford Partnership Comprehensive Biomedical Research Center with funding from the NIHR Biomedical Research Center funding scheme. The views expressed herein are those of the authors and not necessarily those of the NHS, NIHR, Department of Health or any of the other funders. ATP is a Senior Advisor of Intelligent Ultrasound. All other authors declare no competing interests. Consent Statement: All parents provided written informed consent.
(© 2024. The Author(s).)
Databáze: MEDLINE
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