Growth of very low birth-weight Indian infants during hospital stay.

OBJECTIVES To evaluate the growth pattern of Very Low Birth Weight (VLBW) infants (birthweight <1500 g) during hospital stay and to compare the growth of Small for gestational age (SGA) and Appropriate for gestational age (AGA) infants. STUDY DESIGN Prospective observational study. SETTING. Level III Neonatal Intensive Care Unit (NICU) in Northern India. PARTICIPANTS A cohort of 97 VLBW infants, admitted to NICU at Sir Ganga Ram Hospital, from 1 January, 2007 to 31 July, 2008. INTERVENTION/MEASUREMENT: Weight, length and head circumference (HC) were serially measured from birth till discharge and respective Z scores were calculated as per data from Fentons references. Growth was also assessed by superimposing these trends on Ehrenkranzs postnatal growth charts. RESULTS The mean Z scores for weight, length and HC at birth were -1.17, -1.09 and -0.54, respectively. These decreased to -2.16, -2.24 and -1.35, respectively by discharge. Both SGA and AGA infants exhibited a decrease of approximately 1 Z score in all parameters. On postnatal charts, growth of infants remained at or above respective reference lines, except in those below 1000 g at birth. Average daily weight gain after regaining birth weight was 15.18 ± 1.7 g/kg/d, whereas the increase in HC and length were 0.48 ± 0.2 cm/week and 0.60 ± 0.4 cm/week, respectively. These increments when compared to the intrauterine growth rates, indicated discrepant growth trends. CONCLUSIONS VLBW infants suffered significant growth lag during NICU stay and exhibited disproportionately slow growth of HC and length.