[Postnatal growth delay in 27 to 33 week premature infants: frequency and risk factors. Retrospective study of 161 cases].
The optimization of the nutrition of very low birth weight premature neonates has become a major concern given the improvement in survival for these children. The goal of the recommended nutritional intakes is to reach a quantitative and qualitative growth similar to the in utero growth. The objectives of this study were to analyze the anthropometric data at birth and near term in a cohort of premature neonates with birth weight appropriate for gestational age and to try to determine risk factors of postnatal hypotrophy.


METHODS
We conducted a retrospective study over three years (1998-2001) in the neonatology unit of the Armand Trousseau Children's Hospital, Paris, France. The inclusion criteria was a gestational age under 33 weeks with birth weight appropriate for gestational age. Data were collected at admission, during hospitalisation and at discharge and a standardised form was filled for each child. We defined postnatal hypotrophy (PNH) as an hypotrophy at discharge (weight < 10(th) centile according to the Audipog reference curve) in neonates with birth weight appropriate for gestational age.


RESULTS
One hundred and sixty one neonates were included. Eighty two had PNH. In univariate analysis, factors significantly associated with PNH were: birth weight, gestational age, length of hospitalisation, the occurrence of nosocomial infection, of enteropathy, preeclampsia, neonatal asphyxia and antenatal corticoid treatment. In multivariate analysis, risk factors of PNH were: low birth weight, low gestational age and the occurrence of nosocomial infection.


CONCLUSIONS
Our study shows that half of the appropriate for gestational age premature neonates were hypotrophic near term. The causes may be various: nutrition is not optimal and intercurrent factors may play a major role such as nosocomial infection.
Mucignat
V
V
Service de néonatologie, hôpital Armand-Trousseau, AP-HP, 26, avenue du Dr Arnold-Netter, 77571 cedex 12, Paris, France. v.mucignat@trs.ap-hop-paris.fr <v.mucignat@trs.ap-hop-paris.fr>
De Montgolfier-Aubron
I
I
Grillon
C
C
Bourdareau
F
F
Blond
M H
MH
Boëlle
P Y
PY
Lebars
M A
MA
Baudon
J J
JJ
Gold
F
F
D000704:Analysis of Variance; D000886:Anthropometry; D001238:Asphyxia Neonatorum / Q000150:complications; D001724:Birth Weight; D001835:Body Weight; D003428:Cross Infection / Q000150:complications; D005260:Female; D005865:Gestational Age; D006130:Growth Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D006776:Hospitals, Pediatric; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D019102:Infant, Very Low Birth Weight; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010297:Paris / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000150:complications; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D015430:Weight Gain