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Fenton TR, Samycia L, Elmrayed S, Nasser R, Alshaikh B. Growth patterns by birth size of preterm children born at 24-29 gestational weeks for the first 3 years. Paediatr Perinat Epidemiol 2024; 38:560-569. [PMID: 38747097 DOI: 10.1111/ppe.13081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 04/16/2024] [Accepted: 04/21/2024] [Indexed: 09/27/2024]
Abstract
BACKGROUND Concerns are prevalent about preterm infant long-term growth regarding plotting low on growth charts at discharge, stunting, underweight, high body fat and subsequent cardiometabolic morbidities. OBJECTIVES To examine (a) longitudinal growth patterns of extremely and very preterm infants to 3 years corrected age (CA) (outcome), categorised by their birthweight for gestational age: small, appropriate and large for gestational age (SGA, AGA and LGA, respectively) (exposure); and (b) the ability of growth faltering (<-2 z-scores) to predict suboptimal cognitive scores at 3 years CA. METHODS Post-discharge head, length, weight and weight-4-length growth patterns of the PreM Growth cohort study infants born <30 weeks and < 1500 g, who had dietitian and multi-disciplinary support before and after discharge, were plotted against the World Health Organization growth standard. Infants with brain injuries, necrotising enterocolitis and bronchopulmonary dysplasia were excluded. RESULTS Of the included 405 infants, the proportions of infants with anthropometric measures > - 2 z-scores improved with age. The highest proportions <-2 z-scores for length (24.2%) and weight (24.0%) were at 36 gestational weeks. The proportion with small heads was low by 0 months CA (1.8%). By 3 years CA, only a few children plotted lower than -2 z-scores for length, weight-4-length and weight (<6%). After zero months CA, high weight-4-length and body mass index > + 2 z-scores were rare (2.1% at 3 years CA). Those born SGA had higher proportions with shorter heights (16.7% vs. 5.2%) and lower weights (27.8% vs. 3.5%) at 3 years CA compared to those born AGA. The ability of growth faltering to predict cognitive scores was limited (AUROC 0.42, 95% CI 0.39, 0.45 to 0.52, 95% CI 0.41, 0.63). CONCLUSIONS Although children born <30 weeks gestation without major neonatal morbidities plot low on growth charts at 36 weeks CA most catch up to growth chart curves by 3 years CA.
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Affiliation(s)
- Tanis R Fenton
- Community Health Sciences, O'Brien Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Lauren Samycia
- Bachelor of Health Sciences Department, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Seham Elmrayed
- Community Health Sciences, O'Brien Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Institute of Global Health and Human Ecology, American University in Cairo, Cairo, Egypt
| | - Roseann Nasser
- Saskatchewan Health Authority, Nutrition and Food Services, Regina, Saskatchewan, Canada
| | - Belal Alshaikh
- Community Health Sciences, O'Brien Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Sun J, Chong J, Zhang J, Ge L. Preterm pigs for preterm birth research: reasonably feasible. Front Physiol 2023; 14:1189422. [PMID: 37520824 PMCID: PMC10374951 DOI: 10.3389/fphys.2023.1189422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 07/07/2023] [Indexed: 08/01/2023] Open
Abstract
Preterm birth will disrupt the pattern and course of organ development, which may result in morbidity and mortality of newborn infants. Large animal models are crucial resources for developing novel, credible, and effective treatments for preterm infants. This review summarizes the classification, definition, and prevalence of preterm birth, and analyzes the relationship between the predicted animal days and one human year in the most widely used animal models (mice, rats, rabbits, sheep, and pigs) for preterm birth studies. After that, the physiological characteristics of preterm pig models at different gestational ages are described in more detail, including birth weight, body temperature, brain development, cardiovascular system development, respiratory, digestive, and immune system development, kidney development, and blood constituents. Studies on postnatal development and adaptation of preterm pig models of different gestational ages will help to determine the physiological basis for survival and development of very preterm, middle preterm, and late preterm newborns, and will also aid in the study and accurate optimization of feeding conditions, diet- or drug-related interventions for preterm neonates. Finally, this review summarizes several accepted pediatric applications of preterm pig models in nutritional fortification, necrotizing enterocolitis, neonatal encephalopathy and hypothermia intervention, mechanical ventilation, and oxygen therapy for preterm infants.
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Affiliation(s)
- Jing Sun
- Chongqing Academy of Animal Sciences, Chongqing, China
- National Center of Technology Innovation for Pigs, Chongqing, China
- Key Laboratory of Pig Industry Sciences, Ministry of Agriculture, Chongqing, China
| | - Jie Chong
- Chongqing Academy of Animal Sciences, Chongqing, China
- National Center of Technology Innovation for Pigs, Chongqing, China
| | - Jinwei Zhang
- Chongqing Academy of Animal Sciences, Chongqing, China
- National Center of Technology Innovation for Pigs, Chongqing, China
- Key Laboratory of Pig Industry Sciences, Ministry of Agriculture, Chongqing, China
| | - Liangpeng Ge
- Chongqing Academy of Animal Sciences, Chongqing, China
- National Center of Technology Innovation for Pigs, Chongqing, China
- Key Laboratory of Pig Industry Sciences, Ministry of Agriculture, Chongqing, China
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White-Traut RC, Rankin KM, Yoder JC, Liu L, Vasa R, Geraldo V, Norr KF. Influence of H-HOPE intervention for premature infants on growth, feeding progression and length of stay during initial hospitalization. J Perinatol 2015; 35:636-41. [PMID: 25742287 PMCID: PMC4520757 DOI: 10.1038/jp.2015.11] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 12/23/2014] [Accepted: 01/20/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To examine whether premature infants receiving the maternally administered H-HOPE (Hospital to Home Transition-Optimizing Premature Infant's Environment) intervention had more rapid weight gain and growth, improved feeding progression and reduced length of hospital stay, compared with controls. STUDY DESIGN Premature infants born at 29-34 weeks gestational age and their mothers with at least two social-environmental risk factors were randomly assigned to H-HOPE intervention (n=88) or an attention control (n=94) groups. H-HOPE consists of a 15-min multisensory intervention (Auditory, Tactile, Visual and Vestibular stimuli) performed twice daily prior to feeding plus maternal participatory guidance on preterm infant behavioral cues. RESULT H-HOPE group infants gained weight more rapidly over time than infants in the control group and grew in length more rapidly than control infants, especially during the latter part of the hospital stay. CONCLUSION For healthy preterm infants, the H-HOPE intervention appears to improve weight gain and length over time from birth to hospital discharge.
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Affiliation(s)
- R C White-Traut
- 1] Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois, USA [2] Children's Hospital of Wisconsin, Children's Research Institute, Milwaukee, Wisconsin, USA
| | - K M Rankin
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA
| | - J C Yoder
- Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois, USA
| | - L Liu
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA
| | - R Vasa
- 1] Mercy Hospital and Medical Center, Chicago, Illinois, USA [2] Department of Pediatrics, University of Chicago, Chicago, Illinois, USA
| | - V Geraldo
- Sinai Children's Hospital Medical Center, Chicago, Illinois, USA
| | - K F Norr
- Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois, USA
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Sharp M, Campbell C, Chiffings D, Simmer K, French N. Improvement in long-term breastfeeding for very preterm infants. Breastfeed Med 2015; 10:145-9. [PMID: 25786115 DOI: 10.1089/bfm.2014.0117] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The extensive health benefits of breastfeeding preterm infants for both mother and infant have been widely reported. However, establishing and maintaining breastfeeding for very preterm (VP) infants remain challenging. The aim of this study was to examine changes in breastfeeding of VP infants over time. SUBJECTS AND METHODS Breastfeeding questionnaires were administered to two cohorts of parents of VP infants (<32 weeks) cared for at the tertiary perinatal or surgical neonatal unit in Western Australia. Of these, 488 infants were included in cohort 1 (C1) (births from January 1, 1990 to June 30, 1992) and 253 in cohort 2 (C2) (from January 1, 2011 to September 14, 2012). RESULTS More mothers (96.8%) initiated breastfeeding in C2 compared with those in C1 (65.6%) (p<0.001). Additionally, 41.4% of mothers in C2 breastfed for more than 6 months, relative to 25.8% in C1 (p<0.001). The benefits of breastfeeding were endorsed by more women in C2 (45.8%) compared with C1 (11.4%) (p<0.01). Reasons for stopping feeding remained largely consistent. CONCLUSIONS Significant improvements were evident in the initiation and duration of breastfeeding of the VP infant over time. This improvement was associated with attitudinal shifts in mothers about the benefits of breastfeeding.
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Affiliation(s)
- Mary Sharp
- UWA Centre for Neonatal Education and Research , School of Paediatrics and Child Health, Perth, Western Australia, Australia; Neonatal Clinical Care Unit , King Edward Memorial Hospital, Subiaco, Western Australia, Australia
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Ross ES, Browne JV. Feeding Outcomes in Preterm Infants After Discharge From the Neonatal Intensive Care Unit (NICU): A Systematic Review. ACTA ACUST UNITED AC 2013. [DOI: 10.1053/j.nainr.2013.04.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Steward DK. Growth Outcomes of Preterm Infants in the Neonatal Intensive Care Unit: Long-term Considerations. ACTA ACUST UNITED AC 2012. [DOI: 10.1053/j.nainr.2012.09.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Cardoso-Demartini ADA, Bagatin AC, Silva RPGVCD, Boguszewski MCDS. [Growth of preterm-born children]. ACTA ACUST UNITED AC 2012; 55:534-40. [PMID: 22218434 DOI: 10.1590/s0004-27302011000800006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 10/21/2011] [Indexed: 11/22/2022]
Abstract
Children born prematurely might experience a period of growth restriction just after birth. Catch-up growth begins during the first months of life and can be slow and progressive. These children may remain shorter and thinner throughout infancy and childhood compared to children born at term. In some cases, complete catch-up growth occurs only during adolescence. However, some children do not completely recover growth, and adults born prematurely are at increased risk of short stature. Impaired growth is more frequent in those born preterm and small for gestational age. Factors such as target height, birth weight, gestational age, neonatal morbidities and maternal education interfere in growth potential. Special attention should be given to children born preterm during the whole growth period.
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Ghods E, Kreissl A, Brandstetter S, Fuiko R, Widhalm K. Head circumference catch-up growth among preterm very low birth weight infants: effect on neurodevelopmental outcome. J Perinat Med 2011; 39:579-86. [PMID: 21740330 DOI: 10.1515/jpm.2011.049] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS The purpose of this study was to determine whether head circumference (HC) catch-up is associated with improved neurocognitive development. DESIGN A retrospective cohort study was conducted in 179 preterm very low birth weight (VLBW) (BW≤1500 g) infants. The infants were born in 2000-2002 and were followed to the age of 5.5 years. The association between HC catch-up and neurodevelopmental outcome was assessed and perinatal risk factors, infant characteristics and nutritional practices associated with HC catch-up were determined. RESULTS HC catch-up occurred in 59 (34%) infants and was positively correlated with neurodevelopmental outcome. The likelihood of HC catch-up increased with increasing birth weight and gestational age. HC catch-up occurred more often with breast milk feeding during hospitalization and with supplemental formula feeding at discharge, but decreased in prevalence with longer duration of breastfeeding after discharge. HC catch-up was more likely to occur in first-born infants and in families with high socioeconomic status. Most HC catch-up occurred between birth and three months corrected age. CONCLUSION Among preterm-VLBW infants, there is a close relation between HC growth and neurodevelopmental outcome. Efforts to improve neurocognitive outcomes should focus on factors associated with HC catch-up.
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Affiliation(s)
- Elaheh Ghods
- Division of Pediatric Nutrition and Prevention, Department of Pediatrics, Medical University of Vienna, Austria.
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Abstract
BACKGROUND AND OBJECTIVE Bone mineral deficiency continues to occur in extremely-low-birth-weight (ELBW) infants despite formulas enriched in calcium (Ca) and phosphorus (P). This study tested whether extra enteral Ca supplementation increases bone mineral content (BMC) and prevents dolichocephalic head flattening and myopia in ELBW infants. STUDY DESIGN Infants 401 to 1000 birth weight receiving enteral feeds were randomized to receive feeds supplemented with Ca-gluconate powder or pure standard feeds. The main outcome measures were the excretion of Ca and P by weekly spot urine measurements, the degree of dolichocephalic deformation (fronto-occipital diameter to biparietal diameter ratio, FOD/BPD) at 36 weeks postmenstrual age, and the BMC (by dual-energy x-ray absorptiometry) at discharge. Cycloplegic refraction was measured at 18 to 22 months corrected age. PATIENTS AND RESULTS Ninety-nine ELBW infants with a gestational age of 26 weeks (23-31) (median [minimum-maximum]) were randomized at a postnatal age of 12 days (5-23) weighing 790 g (440-1700). Urinary Ca excretion increased and P excretion decreased in the Ca-supplemented group. Total BMC was 89.9 ± 2.4 g (mean ± SE) in the supplemented group and 85.2 ± 2.6 g in the control group (P = 0.19). The FOD/BPD was 1.50 (1.13-1.69, mean ± SD [standard deviation]) and 1.47 (1.18-1.64) in the supplemented and control groups, and the refraction 0.98 ± 1.23 and 1.40 ± 1.33 dpt (P = 0.68), respectively in 64 ELBW infants (79% of survivors) at 2-year follow-up. CONCLUSIONS Extra enteral Ca supplementation did not change BMC, head shape, or refraction. The decreased P excretion may reflect P deficiency in infants receiving extra Ca, preventing improved bone mineral accretion.
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