title: Do early postnatal body weight changes contribute to neonatal morbidities in the extremely low birth weight infants.
abstract: 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.
  
  
  OBJECTIVE
  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.
authors.affiliation: Nassau County University Hospital, East Meadow, NY, USA.
authors.forename: R
authors.initials: R
authors.lastname: Verma
authors.affiliation: LIJ Health System, Manhasset, NY, USA.
authors.forename: S
authors.initials: S
authors.lastname: Shibly
authors.affiliation: University of Colorado, Denver, CO, USA.
authors.forename: H
authors.initials: H
authors.lastname: Fang
authors.affiliation: St John's University, Jamaica, NY, USA.
authors.forename: S
authors.initials: S
authors.lastname: Pollack
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D004374:Ductus Arteriosus, Patent / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D015994:Incidence; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D015431:Weight Loss
chemical_list: D005938:Glucocorticoids
keywords: Extremely low birth weight infants; antenatal steroid; bronchopulmonary dysplasia; intraventricular-periventricular hemorrhage; patent ductus arteriosus; postnatal body weight loss