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396 Factors Associated with Recovery of Growth in Extremely Low Birth Weight Infants

AIMS: To examine the growth pattern through the first 36 months of life in infants born extremely low birth weight (ELBW) and to investigate whether any relationship exists between growth, neonatal characteristics and neurodevelopment outcome at 36 months of chronological age (c.a.).METHODS: One hundred forty-five ELBW infants (mean (SD) gestational age 27.9 (1.9) weeks, birth weight 841 (123) g), consecutively born 1996–2001, without congenital or chromosomal diseases, were evaluated by standardized growth z scores, calculated by the EUROGROWTH software version 2000, through the first 36 months of life. The Griffiths Mental Development Scale (DS) was administered at 36 months of c.a. Statistical analysis was based on Anova for repeated measures and multiple linear regressionRESULTS: Mean (range) weight (W), length (L) and head circumference (HC) at birth were, respectively, 841 (520–1000) g, 34 (26–40) cm, and 25 (20–30) cm. Mean (SD) W, L, and HC z scores recovered through the first 36 months of life (P<0.0001) ranging, respectively, from -2.62 (1.67) at 3 months to-1.85 (1.32) at 36 months (P<0.0001), -2.67 (1.48) to-1.04 (1.13) (P<0.0001), and -1.62 (1.37) to -1.56 (1.06) (P=0.080). At 36 months of c.a. respectively 38%, 17%, 34% of infants had W, L, HC z score <-2. At stepwise multiple regression analysis only birth weight was independently associated with z score for W (adjusted r=0.48, P <0.01), for L (adjusted r=0.41, P <0.01), for HC (adjusted r=0.39, P <0.05). Neonatal characteristics (gender, birth weight, lenght and head circumference, being SGA, gestational age, ventilation) and DS at 36 months entered the model as confounders.CONCLUSIONS: Through the first 36 months of life ELBW infants show progressive recovery of growth, although growth impairment is still present. More unfavourable neonatal anthropometrics appear to be a major factor associated with lower recovery at 36 months.