For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
37
views
20
references
 Top references
cited by
62
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      40
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: not found

      Calculating Postnatal Growth Velocity in Very Low Birth Weight (VLBW) Premature Infants

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objective

          Currently, there is no standardized approach to the calculation of growth velocity (GV; g/kg/day) in hospitalized very low birth weight (VLBW) infants. Thus, differing methods are used to estimate GV, resulting in different medical centers and studies reporting growth results that are difficult to compare. The objective of this study was to compare actual GV calculated from infant daily weights during hospitalization in a Neonatal Intensive Care Unit (NICU) with estimated GV using two mathematical models that have previously been shown to provide good estimated GVs in extremely low birth weight infants: an exponential model (EM) and a 2-Point model (2-PM).

          Study Design

          Daily weights from 81 infants with birth weights of 1000–1499g were used to calculate actual GV in daily increments from two starting points: (1) birth and (2) day of life of regaining birth weight. These daily GV values were then averaged over the NICU stay to yield overall NICU GV from the two starting points. We compared these actual GV with estimated GV calculated using the EM and 2-PM methods.

          Results

          The mean absolute difference between actual and EM estimates of GV demonstrated <1% error for 100% of infants from both starting points. The mean absolute difference between actual and 2-PM estimates demonstrated <1% error for only 38% and 44% of infants from birth and regaining birth weight, respectively. The EM was unaffected by decreasing BW and increasing length of NICU stay, while the accuracy of the 2-PM was diminished significantly (p<.001) by both factors.

          Conclusions

          In contrast to the 2-PM, the EM provides an extremely accurate estimate of growth velocity in larger VLBW infants, and its accuracy is unaffected by common infant factors. The EM has now been validated for use in all VLBW infants to assess growth and provides a simple-to-use and consistent approach.

          Related collections

          Most cited references20

          • Record: found
          • Abstract: found
          • Article: not found

          Longitudinal growth of hospitalized very low birth weight infants.

          Sunita Shankaran, L Papile, Richard Ehrenkranz … (1999)
          The interpretation of growth rates for very low birth weight infants is obscured by limited data, recent changes in perinatal care, and the uncertain effects of multiple therapies. To develop contemporary postnatal growth curves for very low birth weight preterm infants and to relate growth velocity to birth weight, nutritional practices, fetal growth status (small- or appropriate-for-gestational-age), and major neonatal morbidities (chronic lung disease, nosocomial infection or late-onset infection, severe intraventricular hemorrhage, and necrotizing enterocolitis). Large, multicenter, prospective cohort study. Growth was prospectively assessed for 1660 infants with birth weights between 501 to 1500 g admitted by 24 hours of age to 1 of the 12 National Institute of Child Health and Human Development Neonatal Research Network centers between August 31, 1994 and August 9, 1995. Infants were included if they survived >7 days (168 hours) and were free of major congenital anomalies. Anthropometric measures (body weight, length, head circumference, and midarm circumference) were performed from birth until discharge, transfer, death, age 120 days, or a body weight of 2000 g. To obtain representative data, nutritional practices were not altered by the study protocol. Postnatal growth curves suitable for clinical and research use were constructed for body weight, length, head circumference, and midarm circumference. Once birth weight was regained, weight gain (14.4-16.1 g/kg/d) approximated intrauterine rates. However, at hospital discharge, most infants born between 24 and 29 weeks of gestation had not achieved the median birth weight of the reference fetus at the same postmenstrual age. Gestational age, race, and gender had no effect on growth within 100-g birth weight strata. Appropriate-for-gestational age infants who survived to hospital discharge without developing chronic lung disease, severe intraventricular hemorrhage, necrotizing enterocolitis, or late onset-sepsis gained weight faster than comparable infants with those morbidities. More rapid weight gain was also associated with a shorter duration of parenteral nutrition providing at least 75% of the total daily fluid volume, an earlier age at the initiation of enteral feedings, and an earlier age at achievement of full enteral feedings. These growth curves may be used to better understand postnatal growth, to help identify infants developing illnesses affecting growth, and to aid in the design of future research. They should not be taken as optimal. Randomized clinical trials should be performed to evaluate whether different nutritional management practices will permit birth weight to be regained earlier and result in more rapid growth, more appropriate body composition, and improved short- and long-term outcomes.
          Article 0 comments Cited 124 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Randomised trial of early diet in preterm babies and later intelligence quotient.

            A. Lucas, R Morley, T. J. Cole (1998)
            To determine whether perinatal nutrition influences cognitive function at 7 1/2 - 8 years in children born preterm. Randomised, blinded nutritional intervention trial. Blinded follow up at 7 1/2 - 8 years. Intervention phase in two neonatal units; follow up in a clinic or school setting. 424 preterm infants who weighed under 1850 g at birth; 360 of those who survived were tested at 7 1/2 - 8 years. Standard infant formula versus nutrient enriched preterm formula randomly assigned as sole diet (trial A) or supplements to maternal milk (trial B) fed for a mean of 1 month. Intelligence quotient (IQ) at 7 1/2 - 8 years with abbreviated Weschler intelligence scale for children (revised). There was a major sex difference in the impact of diet. At 7 1/2 - 8 years boys previously fed standard versus preterm formula as sole diet had a 12.2 point disadvantage (95% confidence interval 3.7 to 20.6; P<0.01) in verbal IQ. In those with highest intakes of trial diets corresponding figures were 9.5 point disadvantage and 14.4 point disadvantage in overall IQ (1.2 to 17.7; P<0.05) and verbal IQ (5.7 to 23.2; P<0.01). Consequently, more infants fed term formula had low verbal IQ (<85): 31% versus 14% for both sexes (P=0.02) and 47% versus 13% in boys P=0.009). There was a higher incidence of cerebral palsy in those fed term formula; exclusion of such children did not alter the findings. Preterm infants are vulnerable to suboptimal early nutrition in terms of their cognitive performance--notably, language based skills--at 7 1/2 - 8 years, when cognitive scores are highly predictive of adult ones. Our data on cerebral palsy generate a new hypothesis that suboptimal nutritional management during a critical or plastic early period of rapid brain growth could impair functional compensation in those sustaining an earlier brain insult. Cognitive function, notably in males, may be permanently impaired by suboptimal neonatal nutrition.
            Article 0 comments Cited 74 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Accuracy of methods for calculating postnatal growth velocity for extremely low birth weight infants.

              Janet Engstrom, R Kimura, Achchhe Patel … (2005)
              No uniform method for calculating growth velocity (GV) (grams per kilogram per day) among extremely low birth weight (ELBW) infants has been reported. Because the calculation of actual GV is so labor intensive, investigators have estimated GV with varying approaches, making comparisons across studies difficult. This study compares the accuracy of 3 mathematical methods used for estimating average GV, namely, 2-point models using the difference between weights at 2 time points divided by time and weight (either birth weight [BW] or average weight), linear regression models that are normalized for either BW or average weight, and an exponential model. The accuracy of all models was compared with actual GVs calculated from daily weight measures for a group of ELBW infants. Actual GVs were calculated from daily weights for 83 ELBW infants admitted to the special care nursery and were compared with estimated GVs from each of the 5 models for the same infants. The exponential model, using weights from 2 time points, ie, GV = [1000 x ln(Wn/W1)]/(Dn-D1), was extremely accurate, with mean absolute errors of 0.02% to 0.10%. The 2-point and linear models were highly inaccurate when BW was used in the denominator, with mean absolute errors of 50.3% to 96.4%. The 2-point and linear models were fairly accurate when average weight was used in the denominator, with mean absolute errors of 0.1% to 8.97%. Additional analyses showed that the accuracy of the 2-point and linear model estimates was affected significantly by the combination of BW, length of stay, and chronic lung disease, whereas the exponential model was not affected by these combined factors. GV estimates calculated with 3 commonly used models varied widely, compared with actual GVs; however, the exponential model estimates were extremely accurate. The exponential model provides the accuracy and ease of use that are lacking in current methods applied to infant growth research.
              Article 0 comments Cited 71 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-journal-id): 8501884
                Journal ID (pubmed-jr-id): 5061
                Journal ID (nlm-ta): J Perinatol
                Title: Journal of perinatology : official journal of the California Perinatal Association
                ISSN (Print): 0743-8346
                ISSN (Electronic): 1476-5543
                Publication date Nihms-submitted: 16 October 2009
                Publication date (Electronic): 21 May 2009
                Publication date (Print): September 2009
                Publication date PMC-release: 1 March 2010
                Volume: 29
                Issue: 9
                Pages: 618-622
                Affiliations
                [1 ] Pediatrics, Rush University Medical Center, Chicago, IL, United States
                [2 ] College of Nursing, Rush University Medical Center, Chicago, IL, United States
                Author notes
                CORRESPONDING AUTHOR: Aloka L. Patel, MD, Rush University Medical Center, 1653 W. Congress Pkwy, Murdock 622, Chicago, IL 60612. (312)942-6640, fax (312) 942-4370, aloka_patel@ 123456rush.edu
                Article
                Manuscript ID: nihpa106236
                DOI: 10.1038/jp.2009.55
                PMC ID: 2767524
                PubMed ID: 19461590
                SO-VID: 53c6e958-8d67-4702-8219-69494cc1957a
                History
                Funding
                Funded by: National Institute of Nursing Research : NINR
                Award ID: R01 NR010009-01A2 ||NR
                Categories
                Subject: Article

                ScienceOpen disciplines: Pediatrics
                Keywords: premature infant,neonates,growth assessment,birth weight,anthropometry
                Data availability:
                ScienceOpen disciplines: Pediatrics
                Keywords: premature infant, neonates, growth assessment, birth weight, anthropometry

                Comments

                Comment on this article

                scite_

                Similar content40

                See all similar

                Cited by62

                See all cited by

                Most referenced authors226

                See all reference authors