Factors influencing extrauterine growth retardation in singleton-non-small for gestational age infants in China: A prospective multicenter study
Background: The incidence of extrauterine growth retardation (EUGR) varies considerably in different countries due to the distinct definitions and inclusion criteria of individual studies. Most studies included small for gestational age (SGA) very preterm infants (VPIs), resulting in a higher incide...
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Elsevier
2022-11-01
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| Series: | Pediatrics and Neonatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S187595722200153X |
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| author | Ya-Sen Wang Wei Shen Fan Wu Jian Mao Ling Liu Yan-Mei Chang Rong Zhang Xiu-Zhen Ye Yin-Ping Qiu Li Ma Rui Cheng Hui Wu Dong-Mei Chen Zhi Zheng Xin-Zhu Lin Xiao-Mei Tong |
| author_facet | Ya-Sen Wang Wei Shen Fan Wu Jian Mao Ling Liu Yan-Mei Chang Rong Zhang Xiu-Zhen Ye Yin-Ping Qiu Li Ma Rui Cheng Hui Wu Dong-Mei Chen Zhi Zheng Xin-Zhu Lin Xiao-Mei Tong |
| author_sort | Ya-Sen Wang |
| collection | DOAJ |
| description | Background: The incidence of extrauterine growth retardation (EUGR) varies considerably in different countries due to the distinct definitions and inclusion criteria of individual studies. Most studies included small for gestational age (SGA) very preterm infants (VPIs), resulting in a higher incidence of EUGR. Experts have suggested the accurate definition of “EUGR” in SGA infants is not “true EUGR”. The postnatal growth curve of multiple premature births also differs from that of singletons. As far as we know, there is no study about relationship between singleton-non-SGA preterm infants and EUGR. Objectives: To analyze the factors influencing EUGR among VPIs who were singleton-non-SGA in China. Methods: A prospective-multicenter study was conducted in 28 hospitals distributed through China from September 2019 to December 2020. The clinical data on singleton-non-SGA among VPIs were divided into EUGR group (n = 692) and non-EUGR group (n = 912). Results: Compared to non-EUGR group, the mean gestational age (GA), mean birth weight (BW) and percentage of BW in Fenton curve in EUGR group were lower (P < 0.001 for all). The incidence of EUGR among distinct GA groups (classifications of GA < 28weeks, 28–28+6 weeks, 29–29+6 weeks, 30–30+6 weeks and 31–31+6 weeks) and distinct BW groups (classifications of BW<1000 g, 1000–1249 g, 1250–1499 g, 1500–1999g and 2000–2500 g) were statistically significant (P = 0.004 and P <.001). Logistic regression analysis indicated that later addition of human milk fortifier (HMF), later attainment of HMF sufficient fortification, later return to BW, more accumulative days of fasting, longer duration of parenteral nutrition, total duration of oxygen support and moderate/severe bronchopulmonary dysplasia (BPD) were risk factors for the development of EUGR in singleton-non-SGA VPIs (P < 0.001, P = 0.002, P < 0.001, P = 0.002, P = 0.017, P = 0.003 and P = 0.002, respectively). The use of full-course antenatal steroids, greater BW as a percentile of the Fenton curve, breastfeeding initiation and faster average velocity of weight growth effectively protected against EUGR (P = 0.008, P < 0.001, P < 0.001 and P < 0.001, respectively). Conclusions: The overall incidence of EUGR was 43.1% among singleton-non-SGA VPIs in China. Raising the full-course antenatal steroids usage, reducing the incidence of moderate and severe BPD, attaching importance to the management of enteral nutrition in VPIs and increasing the weight growth velocity can reduce the incidence of EUGR. |
| format | Article |
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| institution | DOAJ |
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| publishDate | 2022-11-01 |
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| series | Pediatrics and Neonatology |
| spelling | doaj-art-c7464282ea514ea499f28095c7d76d9e2025-08-20T03:05:14ZengElsevierPediatrics and Neonatology1875-95722022-11-0163659059810.1016/j.pedneo.2022.04.013Factors influencing extrauterine growth retardation in singleton-non-small for gestational age infants in China: A prospective multicenter studyYa-Sen Wang0Wei Shen1Fan Wu2Jian Mao3Ling Liu4Yan-Mei Chang5Rong Zhang6Xiu-Zhen Ye7Yin-Ping Qiu8Li Ma9Rui Cheng10Hui Wu11Dong-Mei Chen12Zhi Zheng13Xin-Zhu Lin14Xiao-Mei Tong15Department of Neonatology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China; Xiamen Key Laboratory of Perinatal-Neonatal Infection, Xiamen, ChinaDepartment of Neonatology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China; Xiamen Key Laboratory of Perinatal-Neonatal Infection, Xiamen, ChinaDepartment of Neonatology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, ChinaDepartment of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Neonatology, Guiyang Maternal and Child Health Hospital·Guiyang Children’ s Hospital, Guiyang, ChinaDepartment of Pediatrics, Peking University Third Hospital, Beijing, ChinaDepartment of Neonatology, Children's Hospital of Fudan University, Shanghai, ChinaDepartment of Neonatology, Guangdong Province Maternal and Children's Hospital, Guangzhou, ChinaDepartment of Neonatology, General Hospital of Ningxia Medical University, Yinchuan, ChinaDepartment of Neonatology, Children's Hospital of Hebei Province, Shijiazhuang, ChinaDepartment of Neonatology, Children’ Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Neonatology, The First Hospital of Jilin University, Changchun, ChinaDepartment of Neonatology, Quanzhou Maternity and Children's Hospital, Quanzhou, ChinaDepartment of Neonatology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China; Xiamen Key Laboratory of Perinatal-Neonatal Infection, Xiamen, ChinaDepartment of Neonatology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China; Xiamen Key Laboratory of Perinatal-Neonatal Infection, Xiamen, China; Corresponding author. Department of Neonatology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China.Department of Pediatrics, Peking University Third Hospital, Beijing, China; Corresponding author.Background: The incidence of extrauterine growth retardation (EUGR) varies considerably in different countries due to the distinct definitions and inclusion criteria of individual studies. Most studies included small for gestational age (SGA) very preterm infants (VPIs), resulting in a higher incidence of EUGR. Experts have suggested the accurate definition of “EUGR” in SGA infants is not “true EUGR”. The postnatal growth curve of multiple premature births also differs from that of singletons. As far as we know, there is no study about relationship between singleton-non-SGA preterm infants and EUGR. Objectives: To analyze the factors influencing EUGR among VPIs who were singleton-non-SGA in China. Methods: A prospective-multicenter study was conducted in 28 hospitals distributed through China from September 2019 to December 2020. The clinical data on singleton-non-SGA among VPIs were divided into EUGR group (n = 692) and non-EUGR group (n = 912). Results: Compared to non-EUGR group, the mean gestational age (GA), mean birth weight (BW) and percentage of BW in Fenton curve in EUGR group were lower (P < 0.001 for all). The incidence of EUGR among distinct GA groups (classifications of GA < 28weeks, 28–28+6 weeks, 29–29+6 weeks, 30–30+6 weeks and 31–31+6 weeks) and distinct BW groups (classifications of BW<1000 g, 1000–1249 g, 1250–1499 g, 1500–1999g and 2000–2500 g) were statistically significant (P = 0.004 and P <.001). Logistic regression analysis indicated that later addition of human milk fortifier (HMF), later attainment of HMF sufficient fortification, later return to BW, more accumulative days of fasting, longer duration of parenteral nutrition, total duration of oxygen support and moderate/severe bronchopulmonary dysplasia (BPD) were risk factors for the development of EUGR in singleton-non-SGA VPIs (P < 0.001, P = 0.002, P < 0.001, P = 0.002, P = 0.017, P = 0.003 and P = 0.002, respectively). The use of full-course antenatal steroids, greater BW as a percentile of the Fenton curve, breastfeeding initiation and faster average velocity of weight growth effectively protected against EUGR (P = 0.008, P < 0.001, P < 0.001 and P < 0.001, respectively). Conclusions: The overall incidence of EUGR was 43.1% among singleton-non-SGA VPIs in China. Raising the full-course antenatal steroids usage, reducing the incidence of moderate and severe BPD, attaching importance to the management of enteral nutrition in VPIs and increasing the weight growth velocity can reduce the incidence of EUGR.http://www.sciencedirect.com/science/article/pii/S187595722200153Xextrauterine growth retardationnutritionrisk factorssingletonsmall for gestational agevery preterm infants |
| spellingShingle | Ya-Sen Wang Wei Shen Fan Wu Jian Mao Ling Liu Yan-Mei Chang Rong Zhang Xiu-Zhen Ye Yin-Ping Qiu Li Ma Rui Cheng Hui Wu Dong-Mei Chen Zhi Zheng Xin-Zhu Lin Xiao-Mei Tong Factors influencing extrauterine growth retardation in singleton-non-small for gestational age infants in China: A prospective multicenter study Pediatrics and Neonatology extrauterine growth retardation nutrition risk factors singleton small for gestational age very preterm infants |
| title | Factors influencing extrauterine growth retardation in singleton-non-small for gestational age infants in China: A prospective multicenter study |
| title_full | Factors influencing extrauterine growth retardation in singleton-non-small for gestational age infants in China: A prospective multicenter study |
| title_fullStr | Factors influencing extrauterine growth retardation in singleton-non-small for gestational age infants in China: A prospective multicenter study |
| title_full_unstemmed | Factors influencing extrauterine growth retardation in singleton-non-small for gestational age infants in China: A prospective multicenter study |
| title_short | Factors influencing extrauterine growth retardation in singleton-non-small for gestational age infants in China: A prospective multicenter study |
| title_sort | factors influencing extrauterine growth retardation in singleton non small for gestational age infants in china a prospective multicenter study |
| topic | extrauterine growth retardation nutrition risk factors singleton small for gestational age very preterm infants |
| url | http://www.sciencedirect.com/science/article/pii/S187595722200153X |
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