Factors Affecting Growth in Infants With Very Low Birth Weight After NICU Discharge From a Tertiary Care Hospital

Sailusha Vadapalli, Aarti Avinash Kinikar, Rahul Dawre, Isha Deshmukh, Uday Rajput, Vaishnavi Bhagat, Sangeeta Chiavale, Sameer Pawar

Abstract

Background and Aim: Adequate postdischarge growth of very low birth weight (VLBW) infants remains an unmet goal, espe¬cially in low-resource settings. This study aimed to identify fac¬tors (at birth, during NICU stay, and after discharge) that are associated with an increased risk of growth failure in VLBW infants discharged from NICUs.

Materials and Methods: This prospective study was conducted at a high-risk follow-up outpatient department (OPD). Anthropometric measurements of all VLBW infants were recorded at discharge and at 1, 3, and 6 months postdischarge along with data on antenatal histories, NICU courses, and postdischarge histories. Weight gain velocities (WGVs) were calculated at each visit, and growth failure rates were estimated and correlated with follow-up compliance.

Results: Of 229 enrolled infants, 164 (71.6%) completed 6 months of follow-up. Growth failure was significantly associated with weight-for-age < 10th percentile at discharge (OR: 12; 95% CI: 1.05, 13.7; P = .012), sepsis requiring oxygen support (OR: 4.03; 95% CI: 0.51, 2.31; P = .04), and receipt of blood transfusions (OR: 1.4; 95% CI: 0.21, 5.14; P = .013). At 1, 3, and 6 months postdischarge, adequate WGVs were observed in 68 (41.4%), 116 (70.7%), and 23 (14%) infants, with 114 (69.5%), 154 (93.9%), and 126 (76.8%) compliant with scheduled follow-ups. At 6 months postdischarge, 26 (15.8%) had appropriate feeding practices (complementary feeds along with breastfeeding).

Conclusions: Weight < 10th percentile at discharge, sepsis requiring ventilation, and the need for blood transfusions during stay at NICU can hinder postdischarge growth of VLBW infants. Strict adherence to follow-up in the first 6 months of discharge, appropriate complementary feeding, early identification of growth failure, and timely nutritional augmentation can enhance growth outcomes.