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Changes in the growth of very preterm infants in England 2006–2018

Changes in the growth of very preterm infants in England 2006–2018
Changes in the growth of very preterm infants in England 2006–2018
Objective: to compare weight gain from birth to term equivalent age in very preterm infants in England born during two eras (2006–2011 and 2014–2018); to assess demographic and care factors influencing weight gain.

Methods: data for infants born before 32 weeks of gestation during 2014–2018 in England were obtained (29 687 infants). Weight gain modelled using SuperImposition by Translation And Rotation (SITAR), with infants grouped by gestational week. A cohort from 2006 to 2011 was used for comparison (3288 infants). Multiple linear regression was used to assess factors influencing change in weight SD score from birth to 36 weeks postmenstrual age.

Results: weight gain velocity (termed ‘intensity’ in SITAR models) was greater in the more recent cohort for all gestation groups born before 30 weeks of gestation. After adjustment for gestation, birth weight and other perinatal factors, care elements associated with faster weight gain included delivery in a level 3 unit (0.09 SD less weight gain deficit, 95% CI: 0.07 to 0.10) and parenteral nutrition initiation during the first day of life (0.08 SD, 95% CI: 0.06 to 0.10). Factors associated with slower weight gain included early ventilation (−0.07 SD, 95% CI: −0.08 to −0.05) and less deprived neighbourhood (−0.012 SD per Index of Multiple Deprivation decile, 95% CI: −0.015 to −0.009).

Conclusions: weight gain for extremely preterm infants was faster during 2014–2018 than during 2006–2011. Early initiation of parenteral nutrition and birth in a level 3 unit may contribute to faster weight gain.
growth, neonatology
1359-2998
267-271
Young, Aneurin
457b536d-6015-4855-8e4c-0a665a9a2bb1
Cole, Tim J.
78cebdf5-e360-4e8e-9dea-ba4b88306980
Cheng, Guo
fdfb3e03-f185-49b1-9c53-05b93bb6c8d0
Ennis, Sarah
7b57f188-9d91-4beb-b217-09856146f1e9
Beattie, Robert M
9a66af0b-f81c-485c-b01d-519403f0038a
Johnson, Mark
ce07b5dd-b12b-47df-a5df-cd3b9447c9ed
Young, Aneurin
457b536d-6015-4855-8e4c-0a665a9a2bb1
Cole, Tim J.
78cebdf5-e360-4e8e-9dea-ba4b88306980
Cheng, Guo
fdfb3e03-f185-49b1-9c53-05b93bb6c8d0
Ennis, Sarah
7b57f188-9d91-4beb-b217-09856146f1e9
Beattie, Robert M
9a66af0b-f81c-485c-b01d-519403f0038a
Johnson, Mark
ce07b5dd-b12b-47df-a5df-cd3b9447c9ed

Young, Aneurin, Cole, Tim J., Cheng, Guo, Ennis, Sarah, Beattie, Robert M and Johnson, Mark (2022) Changes in the growth of very preterm infants in England 2006–2018. Archives of Disease in Childhood: Fetal and Neonatal Edition, 108 (3), 267-271. (doi:10.1136/archdischild-2022-324584).

Record type: Article

Abstract

Objective: to compare weight gain from birth to term equivalent age in very preterm infants in England born during two eras (2006–2011 and 2014–2018); to assess demographic and care factors influencing weight gain.

Methods: data for infants born before 32 weeks of gestation during 2014–2018 in England were obtained (29 687 infants). Weight gain modelled using SuperImposition by Translation And Rotation (SITAR), with infants grouped by gestational week. A cohort from 2006 to 2011 was used for comparison (3288 infants). Multiple linear regression was used to assess factors influencing change in weight SD score from birth to 36 weeks postmenstrual age.

Results: weight gain velocity (termed ‘intensity’ in SITAR models) was greater in the more recent cohort for all gestation groups born before 30 weeks of gestation. After adjustment for gestation, birth weight and other perinatal factors, care elements associated with faster weight gain included delivery in a level 3 unit (0.09 SD less weight gain deficit, 95% CI: 0.07 to 0.10) and parenteral nutrition initiation during the first day of life (0.08 SD, 95% CI: 0.06 to 0.10). Factors associated with slower weight gain included early ventilation (−0.07 SD, 95% CI: −0.08 to −0.05) and less deprived neighbourhood (−0.012 SD per Index of Multiple Deprivation decile, 95% CI: −0.015 to −0.009).

Conclusions: weight gain for extremely preterm infants was faster during 2014–2018 than during 2006–2011. Early initiation of parenteral nutrition and birth in a level 3 unit may contribute to faster weight gain.

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Accepted/In Press date: 13 October 2022
e-pub ahead of print date: 28 October 2022
Published date: 28 October 2022
Additional Information: Funding Information: This study was funded by the NIHR Southampton Biomedical Research Centre. AY is supported by a research fellowship issued by the NIHR Southampton Biomedical Research Centre (no grant number supplied). Publisher Copyright: © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.
Keywords: growth, neonatology

Identifiers

Local EPrints ID: 471966
URI: http://eprints.soton.ac.uk/id/eprint/471966
ISSN: 1359-2998
PURE UUID: bcf297fd-9046-4e99-af98-68db9ff89a90
ORCID for Aneurin Young: ORCID iD orcid.org/0000-0003-3549-3813
ORCID for Sarah Ennis: ORCID iD orcid.org/0000-0003-2648-0869
ORCID for Mark Johnson: ORCID iD orcid.org/0000-0003-1829-9912

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Date deposited: 23 Nov 2022 17:31
Last modified: 17 Mar 2024 04:23

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Contributors

Author: Aneurin Young ORCID iD
Author: Tim J. Cole
Author: Guo Cheng
Author: Sarah Ennis ORCID iD
Author: Robert M Beattie
Author: Mark Johnson ORCID iD

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