title: [Postnatal growth at hospital discharge in extremely premature newborns in Spain].
abstract: BACKGROUND
  Postnatal growth restriction is considered a universal problem in extremely premature infants (EPI), and causes great concern due to the possible relationship between nutrition, sub-optimal postnatal growth, and neurodevelopment delay.
  
  
  OBJECTIVE
  To describe the weight gain in EPI and to determine the changes in the length and head circumference (HC) at hospital discharge in survivors.
  
  
  METHODS
  The study included 4,520 Caucasian EPI from single pregnancies and without severe malformations, born in the centres participating in the Spanish SEN1500 network (2002-2011). The weight was recorded at birth, 28 days, 36 weeks post-menstrual age (PMA), and at discharge. The length and HC were measured at birth and at discharge.
  
  
  RESULTS
  The rate of weight gain (exponential method) was 8.0g/kg/d (birth - 28 days); 14.3g/kg/d (28 days - 36 weeks); and 11.7g/kg/d (36 weeks - discharge). At discharge, postnatal growth restriction was greater for length (z-score between -1.78 and -2.42, depending on GA), followed by weight (-1.67 to -1.79), and HC (-0.69 to -0.81).
  
  
  CONCLUSIONS
  Weight gain in the first weeks after birth is slow in EPI, and they exhibit an almost universal postnatal growth restriction that involves mainly length and weight. In addition to weight, a close control of longitudinal growth and HC are essential for nutritional assessment and detection of patients at risk for poor growth and neurodevelopment after hospital discharge.
authors.affiliation: Servicio de Neonatología, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, España. Electronic address: fgarciamu@gmail.com.
authors.forename: Fermín
authors.initials: F
authors.lastname: García-Muñoz Rodrigo
authors.affiliation: Servicio de Neonatología, Hospital Clínic i Provincial de Barcelona, Barcelona, España.
authors.forename: Josep
authors.initials: J
authors.lastname: Figueras Aloy
authors.affiliation: Departamento de Matemáticas, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España.
authors.forename: Pedro
authors.initials: P
authors.lastname: Saavedra Santana
authors.affiliation: Servicio de Neonatología, Hospital Sant Joan de Déu, Barcelona, España.
authors.forename: Alfredo
authors.initials: A
authors.lastname: García-Alix
mesh_terms: D001827:Body Height; D001835:Body Weight; D002508:Cephalometry; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D062071:Infant, Extremely Premature / Q000254:growth & development*; D007231:Infant, Newborn; D008297:Male; D010351:Patient Discharge; D013030:Spain
keywords: Birth length; Birth weight; Crecimiento posnatal; Extremely premature infant; Head circumference; Longitud al nacimiento; Perímetro craneal; Peso al nacimiento; Postnatal growth; Postnatal growth restriction; Recién nacido extremadamente prematuro; Restricción posnatal del crecimiento