From Tiny Beginnings to Thriving Toddlers: Unravelling Growth Trajectories in Preterm NICU Graduates from a Tertiary Centre in India

Purpose To study the growth patterns of preterm infants less than 35 weeks of gestation. Methods In this retrospective analysis of 653 infants born less than 35 weeks of gestation. Weight, length, and head circumference (HC) were followed up to 12 months of corrected age. Gestational age (GA) corrected z-scores were calculated for the anthropometric measurements at predefined time points. Dropout patterns were summarized, and multiple imputations were used to account for the loss to follow-up. Catch-up and catch-down growth (CDG), and time to reach birth z-score were analyzed. Results The median GA of the study population was 32 weeks at birth (IQR: 29.57, 33.43), and the median birth weight was 1,400 g (IQR: 1,010, 1,820). The z-score for all the anthropometric measurements was lowest at the time of discharge. Cumulative catch-up in weight, HC, and length was demonstrated by 65%, 60%, and 78% of the infants, respectively, by 1 year. 29%, 38%, and 51% of the babies reached the birth z-score at 12 months for weight, HC, and length, respectively. 81%, 69%, and 82% of the babies with abnormal dopplers showed catch-up growth (CUG) by 12 months for weight, HC, and length, respectively. Conclusion While survival outcomes of very low birth weight (VLBW) have improved in low- and medium-income countries, constraints in using appropriate total parenteral nutrition (TPN) and nutritional supplements negatively impact growth.