Submission ID 118506
| Issue/Objective | Background: Extrauterine growth restriction (EUGR) is a frequent condition in preterm infants and is associated with increased risks of delayed development, poor growth, and long-term health complications. In the context of global health, ensuring proper nutrition during the first 1,000 days of life is crucial to help these children reach their full potential in adulthood. Objective: To determine the most suitable definition of EUGR and assess its prevalence, associated factors, and morbi-mortality during the first year of life in preterm infants followed in three outpatient Kangaroo Mother Care (KMC) programs in Colombia. |
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| Methodology/Approach | This study included a case-control design to identify associated factors and a cohort analysis for morbidity and mortality. Preterm infants (<35 weeks GA, ≥12 days hospitalization) admitted between September 2021 and October 2023 were included. Exclusion criteria were intrauterine growth restriction at birth, congenital malformations, metabolic disorders, gastrointestinal or renal conditions, or genetic syndromes intrinsically affecting growth. Sociodemographic, gestational, perinatal, and hospitalization-related factors were analyzed, along with anthropometric growth, neurodevelopment, feeding patterns, rehospitalizations, and mortality during the first year of life. Conditional logistic regression and GEE models were applied. Sample size: 645 infants (215 with EUGR, 430 without). The study was approved by the ethics committees of Javeriana University and Kangaroo Foundation. |
| Results | EUGR prevalence ranged from 30-40%, depending on longitudinal vs. cross-sectional definitions. Associated factors included low birth weight percentile, delayed weight regain, inadequate parenteral nutrition, longer hospital stay, limited kangaroo care time, and hemodynamically significant ductus arteriosus. Cross-sectional EUGR identified more severe nutritional decline, while longitudinal criteria allowed earlier detection. EUGR was associated with worse anthropometric outcomes at 12 months, greater neurodevelopmental delays, higher oxygen dependence, more frequent rehospitalizations, and increased mortality. Head circumference at 12 months was also linked to socioeconomic status. |
| Discussion/Conclusion | EUGR must be assessed longitudinally for timely intervention. Strategies to ensure adequate inpatient nutrition, support prolonged kangaroo care, and address common medical complications like patent ductus arteriosus are critical to prevent growth failure. EUGR significantly impacts survival, growth and development, highlighting the need for global comprehensive nutritional strategies in neonatal care. |
| Presenters and affiliations | Adriana Montealegre-Pomar Kangaroo Foundation and Pontificia Universidad Javeriana Adriana Montealegre-Pomar Kangaroo Foundation and Pontificia Universidad Javeriana Nathalie Charpak Kangaroo Foundation |
