Infant, Premature Clinical Trial
Official title:
Growth Observational Study
This study was a multicenter, prospective cohort study to define postnatal longitudinal growth for very low birth weight (VLBW) infants. The objectives were: 1) to develop postnatal growth curves for VLBW preterm infants that would permit an assessment of growth velocity; 2) to relate growth velocity and nutritional practices (duration of parenteral nutrition, age at first enteral feeding, and age at full enteral feeding); 3) to compare growth velocity in infants who are small-for-gestational age (SGA) with infants who are appropriate-for-gestational age (AGA); and 4) to relate growth velocity to several common, major morbidities, including chronic lung disease (CLD), nosocomial infection (or late-onset infection) and necrotizing enterocolitis (NEC). These growth data may be useful in identifying preterm infants who are growing slowly despite current nutritional support and in designing and performing clinical trials of nutritional interventions.
Previous growth curves for premature infants were based on a 1948 study of 100 infants. More
recent reports described growth rates for VLBW infants exceeded those predicted by the
previous study. The authors suggested that the differences may reflect changes in
nutritional management and cautioned that the observed growth rates may not be optimal.
Although a greater number of extremely low birth weight infants were included in these
studies, data for infants with birth weights <750 g was still limited.
This study was a multicenter, prospective cohort study to define postnatal longitudinal
growth for very low birth weight (VLBW) infants. The objectives were: 1) to develop
postnatal growth curves for VLBW preterm infants that would permit an assessment of growth
velocity; 2) to relate growth velocity and nutritional practices (duration of parenteral
nutrition, age at first enteral feeding, and age at full enteral feeding); 3) to compare
growth velocity in infants who are small-for-gestational age (SGA) with infants who are
appropriate-for-gestational age (AGA); and 4) to relate growth velocity to several common,
major morbidities, including chronic lung disease (CLD), nosocomial infection (or late-onset
infection) and necrotizing enterocolitis (NEC). These growth data may be useful in
identifying preterm infants who are growing slowly despite current nutritional support and
in designing and performing clinical trials of nutritional interventions.
Data were collected on 1660 infants with birth weights between 501 to 1500 g who were inborn
or admitted at 24 hours of age or less to 1 of the 12 National Institute of Child Health and
Human Development (NICHD) Neonatal Research Network centers between August 31, 1994 and
August 9, 1995, survived >7 days (168 hours) and were free of major congenital anomalies.
Infants were weighed daily for a minimum of 14 days or until birth weight was regained,
whichever occurred later, and then weekly. Recumbent length was measured weekly with a
Premie Length Board. Head circumference (HC) was measured weekly. Midarm circumference (MAC)
was measured weekly. Length, HC, and MAC measurements were each performed twice.
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Observational Model: Cohort, Time Perspective: Prospective
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