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Factors Associated with Extrauterine Growth Restriction in
Very Low Birth Weight Infants
Sudathip Kositamongkol, Claire Komarapaj*
Department of Pediatrics, Faculty of Medicine, Thammasat University
*Corresponding Author E-mail: komarapajc@gmail.com
Background: Abstract
Background: Very low birth weight (VLBW) infants are at risk of extrauterine growth failure
(EUGR), which is associated with poor neurodevelopment in early childhood. Based on
current definitions, there are 2 types of EUGR: static and dynamic’. This study aims to (1)
determine the risk factors significantly associated with each type of EUGR, and (2) how
similar the risk factors are between the two types of EUGR.
Methods: Results: Conclusion: This is a retrospective observational study undertaken in a single tertiary hospital. Excluding
infants that died before discharge and those that have chromosomal or syndromic
anomalies, data from 88 very low birth weight (VLBL) infants that weighed <1500 grams at
birth were studied. Prenatal risk factors and postnatal morbidities were analyzed to see if
they are associated with the outcome of static or dynamic EUGR.
Of the 107 infants enrolled in this study, 55 infants met the definition for static and 35 for
dynamic EUGR. Risk factors that are significantly associated with static EUGR are Small for
GA (SGA) at birth (OR 1.282; 95%CI 0.888-1.848) and delayed full feeding (OR 3.66; 95%CI
1.082-12.410). The only risk factor found to be significantly associated with dynamic EUGR
is delayed full feeding (OR 5.283; 95% CI 1.587-17.587). Kappa analysis was calculated to
be 0.175, which reveals a poor correlation between static and dynamic EUGR.
Infants with VLBW have a high incidence under both definitions of EUGR. It is a
multifactorial disorder with many associated causes but delayed full feeding seems to have
had the most significant impact on both static and dynamic EUGR. This implies a need to
pay more attention to nutritional practices in neonatal care units so VLBW infants may see
more optimal outcomes.
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