Extrauterine Growth Restriction and Catch-up Growth Following NICU Discharge: a Tale of two Standards

Abstract

Abstract Objectives: To assess extrauterine growth restriction (EUGR) after neonatal intensive care unit (NICU) discharge and identify factors associated with catch-up growth (CUG) and neurodevelopmental outcomes at age 2. Study Design: Growth parameters at birth, 36 weeks postmenstrual age (PMA), and two neurodevelopmental follow-up visits were reviewed retrospectively. EUGR was assessed using Fenton and Intergrowth-21 standards. Factors associated with outpatient growth and neurodevelopmental outcomes at age 2 were evaluated using logistic and linear regression. Results: 369 infants comprised the cohort. EUGR prevalence was 14.9% for Intergrowth-21 vs. 56.4% for Fenton (p < 0.001). There was a significant decrease in weight z-score from birth-36 weeks PMA. Weight z-scores returned to birth values by the 2nd clinic visit. Formula-fed infants had faster CUG. Higher Bayley-III at age 2 were associated with human milk feeding. Conclusions: Fewer infants were EUGR using Intergrowth-21. CUG with return to birth weight z-score was seen. Human milk feeding positively impacted Bayley-III scores, despite slower CUG.