Journal List > Perinatology > v.28(2) > 1071366

Kim and Jung: The Clinical Features Based on Different Weight Percentile in Appropriate for Gestational Age Preterm Infants

Abstract

Objective

To determine whether different weight percentiles influence the clinical characteristics and growth in appropriate for gestational age preterm infants.

Methods

We collected data retrospectively on preterm infants (n=176; gestational age <35 weeks; birth weight <2,500 g) admitted to neonatal intensive care unit from March 2009 to August 2010. Infants were divided according to birth and weight loss percentile during the admission period.

Results

A total of 161 infants were included in the study. Study data showed that the birth percentiles of 135 (84%) infants decreased at discharge and the rest 26 (16%) remained the same. Female infants were discharged at a significantly lower weight percentile than male. Infants with high birth weight percentile had a reduced weight percentile at discharge. For the infants with decreased weight percentile at discharge the length of birth weight recovery was longer and the maximal weight loss was greater (P<0.05). And considering their weights at discharge, these infants also showed a statistically higher percentage of extrauterine growth restriction.

Conclusion

Even though infant's weight is appropriate for gestational age, premature infants possibly fail to keep up with their birth weight percentile and show extrauterine growth restriction at discharge. Therefore, we should make more efforts to prevent postnatal growth failure for the appropriate growth.

REFERENCES

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Fig. 1
Flowchart of the preterm infants’ group by weight percentile at birth and discharge. GA, gestational age; BW, birth weight; AGA, appropriate for gestational age; SGA, small gestational for age; LGA, large for gestational age.
pn-28-41f1.tif
Fig. 2
Group classification according to (A) weight percentiles of intrauterine growth and (B) different weight percentile between birth and discharge.
pn-28-41f2.tif
Table 1.
Clinical Features among Groups
  Group I (n=26) Group II (n=84) Group III (n=51) P-value
Weight percentile at birth 2.1±0.8 2.5±0.7 2.9±0.7 0.000
Weight percentile at discharge 2.1±0.8 1.5±0.7 0.9±0.7 0.000
GA (wks) 31+1±2+5 31+3±2+6 31+0±2+4 0.520
BW (g) 1,590.4±432.2 1,667.0±471.2 1,612.3±422.7 0.565
Apgar score (1 min) 6.0±1.8 6.2±1.7 6.0±1.6 0.794
Apgar score (5 min) 8.2±0.6 8.2±0.9 8.1±0.8 0.597
Female 8 (31) 39 (46) 31 (61) 0.039
RDS 5 (19) 16 (19) 9 (18) 0.976
PDA ligation 0 (0) 2 (2) 0 (0) 0.395
BPD 6 (23) 8 (10) 4 (8) 0.105
Sepsis 2 (8) 8 (10) 7 (14) 0.650
TPN duration (day) 16.9±13.5 18.0±14.5 19.2±13.0 0.445
HD (day) 47.1±33.1 37.6±25.2 41.7±24.7 0.408

Values are presented as mean±standard variation or number (%). Abbreviations: GA, gestational age; BW, birth weight; RDS, respiratory distress syndrome; PDA, patent ductus arteriosus; BPD, bronchopulmonary dysplasia; TPN, total parenteral nutrition; HD, hospital duration.

Table 2.
Obstetric Factors among Groups
  Group I (n=26) Group II (n=84) Group III (n=51) P-value
C-sec delivery 18 (69) 57 (68) 34 (67) 0.974
Multiple birth 9 (35) 26 (31) 16 (31) 0.939
Antenatal antibiotics 9 (35) 40 (48) 27 (53) 0.312
Antenatal steroid 20 (77) 52 (62) 41 (80) 0.054
Antenatal MgSO4 2 (8) 10 (12) 0 (0) 0.038
IVF 3 (12) 7 (8) 4 (8) 0.850
PIH 1 (4) 7 (8) 4 (8) 0.742
GDM 0 (0) 4 (5) 2 (4) 0.532
Chorioamnionitis (clinical) 2 (8) 18 (21) 14 (27) 0.132
PROM ≥24 hours 8 (31) 23 (27) 18 (35) 0.625

Values are presented as number (%). Abbreviations: IVF, in vitro fertilization; PIH, pregnancy induced hypertension GDM, gestational diabetes mellitus; PROM, premature rupture of membranes.

P<0.05 compared to group I.

Table 3.
Factors Associated with Growth among Groups
  Group I (n=26) Group II (n=84) Group III (n=51) P-value
Day of first feeding 2±1 2±2 2±2 0.841
Day of full feeding 20±13 20±13 22±14 0.593
Maximal weight loss (%) 9.4±5.5 10.8±5.3 13.3±4.8 0.001
Day of recovery to BW 12±5 13±5 16±5 0.000
EUGR 0 (0) 7 (8) 17 (33) 0.000

Values are presented as mean±standard variation or number (%). Abbreviations: BW, birth weight; EUGR, extrauterine growth restriction.

Table 4.
Characteristics between Two Groups Divided by the 50th Percentile Birth Weight
  ≤50 percentile (n=76) >50 percentile (n=85) P-value
GA (weeks) 31+1±3+1 31+2±2+2 0.895
BW (g) 1,498.0±444.4 1,761.8±416.8 0.000
BW <1,500 g 38 (50) 24 (28) 0.005
Apgar score (1 min) 5.7±1.8 6.4±1.5 0.004
Apgar score (5 min) 8.0±1.0 8.3±0.6 0.009
Female 43 (57) 35 (41) 0.051
C-sec delivery 56 (74) 53 (62) 0.125
Multiple birth 29 (38) 22 (26) 0.095
Antenatal steroid 53 (70) 60 (71) 0.906
Antenatal MgSO4 9 (12) 3 (4) 0.045
IVF 10 (13) 4 (5) 0.057
PIH 7 (9) 5 (6) 0.422
GDM 2 (3) 4 (5) 0.488
Antenatal antibiotics 32 (42) 44 (52) 0.220
PROM ≥24 hours 26 (34) 23 (27) 0.325
Maximal weight loss (%) 11.7±5.7 11.0±5.0 0.390
Day of recovery to BW 14±5 14±5 0.590
RDS 19 (25) 11 (13) 0.050
BPD 14 (18) 4 (5) 0.006
Postnatal steroid therapy 8 (11) 2 (2) 0.032
Sepsis 9 (12) 8 (9) 0.616
Day of first feeding 1.6±1.8 1.6±1.3 0.997
Day of full feeding 23±15 18±10 0.021
TPN duration (day) 20.7±16.7 15.9±10.2 0.032
Hospital duration (day) 46.0±30.7 35.4±21.0 0.013
EUGR 22 (29) 2 (2) 0.000

Values are presented as mean±standard variation or number (%). Abbreviations: GA, gestational age; BW, birth weight; IVF, in vitro fertilization; PIH, pregnancy induced hypertension; GDM, gestational diabetes mellitus; PROM, premature rupture of membranes; RDS, respiratory distress syndrome; BPD, bronchopulmonary dysplasia; TPN, total parenteral nutrition; EUGR, extrauterine growth restriction.

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