Authors: Verma, R. | Shibly, S. | Fang, H. | Pollack, S.
BACKGROUND: The implications of early postnatal body weight changes (Δbw ) in the morbidities related to body fluid metabolism in sick preterm infants in not well investigated. The extremely low birth weight infants (ELBW, birth weight <1000 g) have the highest incidence of such morbidities among all neonates. AIM: To determine the relationships between Δbw and neonatal morbidities associated with body fluid metabolism in the ELBW infants. METHODS: In an observational study, the associations between daily weight changes from birth weight (DΔ bw ) and oxygen dependence on postnatal day 28 (BPD28),
…patent ductus arteriosus (PDA), intraventricular-periventricular hemorrhage (IVH), antenatal steroid (ANS) and gestational age (GA) were evaluated. Maximum weight loss (MΔ bw ) was correlated with GA, BPD28 and BPD36 (oxygen dependence on postmenstrual 36 weeks). Pearson’s correlation co-efficient and multivariate logistic regressions were performed for analysis. RESULTS: DΔ bw correlated inversely with GA on days 1–8 of life (p < 0.01 for all, 0.06 for DOL 2). DΔ bw was associated with a lower risk of BPD28 on days 6 (OR 0.87, 95% CI 0.76–1), 10 (OR 0.86, 95% CI 0.76–0.98) and 11 (OR 0.87, 95% CI 0.77–0.99); with PDA on days 8–11 (OR ranging between 0.89 to 0.92 for the 4 days, 95% CI 0.83 to 0.99) and with IVH on day 5 (OR 0.93, 95% CI 0.86–1) after controlling for GA. DΔ bw was not identified as risk factor for the tested morbidities. ANS decreased DΔ bw on days 4 (OR 0.88, 95% CI 0.78–1) and 10 (OR 0.9, 95% CI 0.84–1). MΔbw correlated directly with BPD28 (r = 0.3, p = 0.004), which declined after controlling for GA (r = 0.2, p = 0.2). CONCLUSIONS: DΔ bw is protective for PDA, BPD28 and IVH, independent of gestational age, whereas, the effects of MΔ bw on BPD are governed by maturation in ELBW infants. ANS decreases DΔbw , which correlates inversely with GA during the first week of life.
Keywords: Extremely low birth weight infants, postnatal body weight loss, patent ductus arteriosus, bronchopulmonary dysplasia, antenatal steroid, intraventricular-periventricular hemorrhage
Citation: Journal of Neonatal-Perinatal Medicine,
vol. 8, no. 2, pp. 113-118, 2015
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