Factors influencing the growth of preterm infants in the first two years of life

影响早产儿出生后头两年生长发育的因素

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Abstract

OBJECTIVE: To identify maternal and neonatal factors associated with growth outcomes in preterm infants (PT) born before 33 weeks of gestation, assessed at 24 months corrected age (CA). METHODS: Prospective cohort study with PT <33 weeks' gestation, discharged from the Neonatal Intensive Care Unit of a university hospital between 2019 and 2021, followed at the high-risk outpatient clinic. Variables analyzed: Maternal - sociodemographic aspects, gestational morbidities, selfefficacy score (confidence that parents have in their ability to perform the tasks of parenthood); Newborn - data from birth, hospital stay and post-discharge, measures of weight, height and head circumference at birth, discharge and follow up (seven evaluations). Outcome: Z scores of anthropometric measurements and growth failure (Z score <-2) at 24 months CA. Data were analyzed by hierarchical logistic or linear regression models in blocks. RESULTS: 99 PT with a mean gestational age of 30.2±2.0 weeks were studied. Intrauterine growth restriction (fetus that fails to reach its growth percentage, caused by maternal/placental factors) and being born small for gestational age (<10th percentile according to Fenton's calculator) were predictors of growth failure. Time to achieve full enteral feeding, necrotizing enterocolitis and maternal self-efficacy were associated with anthropometric measurements at 24 months. CONCLUSIONS: The growth of PT in the first 24 months CA is influenced by the nutritional condition at birth, nutritional evolution during hospitalization and maternal self-efficacy. Optimizing nutritional practices for PT and stimulating maternal self-efficacy are possibilities for improving growth in the early years.

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