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Exposure to placental insufficiency alters postnatal growth trajectory in extremely low birth weight infants

Published online by Cambridge University Press:  04 October 2019

Fu-Sheng Chou Open the ORCID record for Fu-Sheng Chou [Opens in a new window] ,
Hung-Wen Yeh ,
Chu-Yen Chen ,
Gene T. Lee ,
Marc R. Parrish ,
Mmeyeneabasi Omede  and
Vishal Pandey
Fu-Sheng Chou
Affiliation:
Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA Division of Neonatology, Children’s Mercy Kansas City, Kansas City, MO, USA
Hung-Wen Yeh
Affiliation:
Division of Health services and Outcomes Research, Children’s Mercy Kansas City, Kansas City, MO, USA
Chu-Yen Chen
Affiliation:
Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA
Gene T. Lee
Affiliation:
Department of Obstetrics and Gynecology, University of Kansas Medical Center, Kansas City, KS, USA
Marc R. Parrish
Affiliation:
Department of Obstetrics and Gynecology, University of Kansas Medical Center, Kansas City, KS, USA
Mmeyeneabasi Omede
Affiliation:
Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA
Vishal Pandey*
Affiliation:
Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA Division of Neonatology, Children’s Mercy Kansas City, Kansas City, MO, USA
*
Address for correspondence: Vishal Pandey, Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Blvd., Kansas City, KS 66160, USA. Email: vpandey@kumc.edu
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Abstract

Growth in the immediate postnatal period for extremely low birth weight (ELBW, birth weight < 1000 g) infants is an important topic in neonatal medicine. The goal is to ensure adequate postnatal growth and to minimize complications resulting from suboptimal growth. Past efforts have focused on postnatal nutrition as well as on minimizing comorbidities. It has not been systematically assessed whether antenatal factors play a role in postnatal growth. In this report, we conducted a retrospective study on 91 maternal–neonatal pairs. We prospectively collected maternal and neonatal demographic data, neonatal nutrition in the first 7 days of life and after enteral nutrition is fully established, comorbidity data, as well as weight data from birth to 50 weeks corrected gestational age. We developed a linear mixed-effects model to examine the role of placental insufficiency, as defined by fetal Doppler studies, in postnatal weight z-score trajectory over time in the ELBW population. We relied on Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) for model selection. Interestingly, the selected model included a quadratic term of time and a placental insufficiency-by-time interaction term. In a covariate analysis, AIC and BIC both favored a model that included calories intake in the first 7 days of life and the total duration of antibiotics as fixed-effects, but not their interaction terms with time. Overall, we demonstrated for the first time that placental insufficiency, an antenatal factor, is a major determinant of postnatal weight trajectory in the ELBW population. Prospective studies are warranted to confirm our findings.

Keywords

Postnatal growthplacental insufficiencyextremely low birth weightpremature infant
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 11 , Issue 4 , August 2020 , pp. 384 - 391
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2019

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