Post natal growth pattern of very low birth weight infants up to corrected 40 weeks of gestational age

Background: We all know, increase in survival of NICU graduates result in increment in numbers of very low birth weight babies and extremely low birth weight babies. Intra uterine milieu provides unlimited supply of nutrients, protection from hypothermia and microbial invasions, which turns into intermittent supply of nutrients and risk of sepsis when a neonate comes outside. Aim: To observe the growth parameters in VLBW infants postnataly up to 40 weeks post menstrual age (PMA) by plotting the growth trends on Fenton’s postnatal growth curves and on WHO growth charts at 40 weeks PMA. Materials and methods: Prospective observational study was carried out at Level III NICU in West India. 110 VLBW infants admitted from July 2012 to September 2013 were included in the study. Length, head circumference (HC) and mid arm circumference were measured within 48 hours of birth and then weekly. Growth pattern obtained till 40 weeks PMA and then plotted. Results: We found that average daily weight gain of this cohort was 17.7(+/-7.8) g/kg/day which was comparable to intrauterine growth velocity. In addition, the average weekly increment in length and HC was 0.52 and 0.39 cm/wk respectively, not comparable to intrauterine growth. On Fenton’s 2013 sex specific growth curves, all infants showed significant growth lag and at 40 weeks PMA, on WHO standard growth curves, 2006 they all lie at 3rd centile or below. Conclusions: We need large multi centric prospective cohort study to explore the growth trends of VLBW babies in India to develop Post natal growth nomograms for VLBW babies. Long term growth of VLBW infants should be monitored as they are at risk of growth failure.