Evaluation of postnatal weight growth in very low birth weight infants

There is general agreement about the need for longitudinal studies of very low birth weight infants (VLBWI) to evaluate their postnatal growth and to generate distance and velocity charts that allow neonatologists and pediatricians to detect earlier whether a child is not growing adequately. There are no satisfactory growth charts for VLBWI. We analyzed the weight growth of 262 VLBWls from birth to 2 years of corrected age. Individual growth profiles were fitted with a 7-constant exponential-logistic function suitable for modelling weight growth pattern. After a postnatal weight loss, all VLBWls showed a late neonatal peak of velocity between the seventh and 21st weeks; the large majority of them also experienced an early neonatal peak between the second and the sixth weeks. Small-for-gestational-age VLBWls with major morbidities grew less than reference appropriate-for-gestational-age VLBWIs without major morbidities: at 2 years, the difference in weight was about 860g. The more severe growth impairment in VLBWls with major morbidities was almost entirely due to the reduced height of the late neonatal peak of velocity. The mathematical function used in this study is expected to be a useful tool to trace model-based longitudinal distance and velocity charts specific for VLBWls. Moreover, this function also could be used to evaluate to what extent different pathological conditions or nutritional and medical care protocols affect growth kinetics.