Three-year growth trajectories and catch-up patterns in extremely low birth weight infants: a focus on early nutritional interventions

Ashraf T Soliman; Fawzia Alyafei; Vincenzo De Sanctis; Nada Alaaraj; Noor Hamed; Shayma Ahmed; Hamdy Ali; Mohamed Alkuwari

doi:10.23750/abm.v95i3.15510

Three-year growth trajectories and catch-up patterns in extremely low birth weight infants: a focus on early nutritional interventions

Authors

Ashraf T Soliman Department of Pediatrics, Hamad General Hospital, Doha, Qatar
Fawzia Alyafei Department of Pediatrics, Hamad General Hospital, Doha, Qatar
Vincenzo De Sanctis Pediatric and Adolescent Outpatient Clinic, Private Accredited Quisisana Hospital, Ferrara, Italy
Nada Alaaraj Department of Neonatology, Women Wellness and Research Center, Doha, Qatar
Noor Hamed Department of Pediatrics, Hamad General Hospital, Doha, Qatar
Shayma Ahmed Department of Pediatrics, Hamad General Hospital, Doha, Qatar
Hamdy Ali Department of Neonatology, Women Wellness and Research Center, Doha, Qatar
Mohamed Alkuwari Department of General Pediatrics, Hamad General Hospital, Doha, Qatar

DOI: https://doi.org/10.23750/abm.v95i3.15510

Keywords:

Extremely low birth weight, infants, postnatal growth, weight, length, head circumference

Abstract

Introduction: Growth trajectories of preterm infants, particularly those with extremely low birth weight (ELBW) defined as less than 750 grams, are notably complex and highly variable. Objective: We tracked the growth patterns of 35 ELBW infants born in a tertiary care facility, fed with preterm formula for the first 3-6 months of life. Results: ELBW infants showed significant initial deficits in weight, length, and head circumference, yet demonstrated considerable catch-up growth over 3 years. The initial mean weight-for-age Z-score (WAZ) was - 8.70, a stark deviation from the median of the reference population. By 36 months, the WAZ improved to -1.24, although 25.7% of infants continued to be underweight. The length-for-age Z-score (LAZ) began at -9.95, indicative of a pronounced deficiency in length, but by the third year, it had markedly improved to -0.35, with 11.4% of infants still measuring below the norm. The weight-for-length Z-score (WLZ) was initially -19.41, suggesting acute malnutrition; however, it fluctuated and improved to -1.75 by 36 months, with 31.4% of the cohort still at risk for malnutrition. Head circumference-for-age Z-score (HCZ) showed an initial value of -9.52 and improved to -1.75 by 36 months, but recovery in head growth was slower, with 6 out of 35 infants remaining below the reference curve. Conclusion: Our findings reveal that ELBW infants exhibit significant improvements in WAZ, LAZ, WLZ, and HCZ over a period of three years, with most of the catch-up growth occurring within the first year, and LAZ continuing to improve into the third year.

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