Volume 8, Issue 3, March – 2023 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165

Growth Monitoring of VLBW Babies in NICU

1 2
Dr. Venugopal Reddy I, Dr. Sravan Kumar Reddy. M,
Medical Director and Consultant Pediatrician, Consultant Pediatrician, Bangalore
Ovum Hospital, Bangalore

Abstract:- A child that was born with a veritably low However, there was a noticeable growth stop during the
birth weight (VLBW) is more likely to have stunted NICU stay, and HC and length grew disproportionately
growth as a result of particular intrauterine slowly. babies withco- morbidities like NEC and feed
circumstances, exposure to unfavourable extrauterine sectarianism showed a significant decline in growth
environments, and unmet nutritional needs. Despite haste. ELBW babies swerved significantly from the
advancements in newborn care, extrauterine growth reference growth charts due to advanced morbidity.
slows down in VLBW kids due to early immaturity and a
growth stop during the neonatal period.( EUGR). Keywords: SGA Infants, Weight Gain, Post Natal Growth,
Numerous studies have demonstrated catchup growth Gutbrod, Birth Weight, VLBW Infants, Sanket.
during these periods, but others have established little or
no catchup growth. As there are numerous concerns I. INTRODUCTION
regarding the particular nutritional conditions of these
newborns and evidence of variances amongst NICUs in The truly low birth weight (VLBW) kid, whose birth
terms of nutritive operation of these babies, there is weight is less than 1500 g, is more likely to experience
continuous discussion in connection to defining suitable stunted growth as a result of specific intrauterine
nutritive input for these infants. The stark disparities in circumstances, exposure to adverse extrauterine
how NICUs are set up among them provide evidence for environments, and poorly understood nutritional conditions.
the connection of nutrient supply and growth. According VLBW kids continue to experience growth stop during the
to the predominant idea, preterm infants in the NICU neonatal period and early childhood despite advancements
receive inadequate nourishment, which causes slow in neonatal care. It has been demonstrated that growth
growth in the first few weeks of life. This study aims to tracking is a helpful and cost-effective technique in primary
characterize, validate, and analyse any differences, if healthcare, although it is confounded by a number of issues.
any, between those born small for gestational age or The origins of impaired growth begin during the first
otherwise between VLBW infants while they are in the numerous weeks of life. VLBW babies will witness some
NICU.( AGA or SGA). SGA newborns exhibited loss of birth weight in the immediate postnatal period, but
significantly lower mean Z scores at delivery for weight, the period between nadir of weight loss and return to birth
length, and head circumference compared to AGA weight is largely variable. Once birth weight is reacquired,
babies, indicating a significant intrauterine growth they witness slow rates of weight gain performing in shy
retardation. Premature birth increases the risk of SGA growth during the first numerous weeks of life, leading to
babies by twofold, as does slow growth in the early extrauterine growth retardation( EUGR). ultimate of these
postnatal period. This study examined the goods of babies substantiation catch up growth important
parenteral nutrition and trophic feeds on the weight gain subsequently, by 8- 20 times. Catchup growth during their
of VLBW babies from day 1 of life. All babies entered an early times has been shown in a number of studies, but some
average calorie input of 132 kcal/ kg/ day and endured a studies have set up little or no catchup growth. Poor growth
quotidian weight gain of19.3 g/ kg/d. Average weight may be predictive of poor neurodevelopmental outgrowth,
gain per day is lower in SGA babies(18.14 ±1.11) particularly in those children with lower head sizes.(, 2)
compared to AGA(21.021.52) babies, but this is various factors may impact the postnatal growth of VLBW
statistically not significant( p = 0.178). KMC babies babies, analogous as maturity and growth status at birth,
gained farther weight per day by discharge than perinatal clinical conditions, socio-provident factors,
controls and had a larger head circumference at 6 heritable background, feeding practices and feeding
months corrected age than controls. For every 250 g problems. The understanding of the association between
order on Ehrenkranz's charts, postnatal growth fell these factors and postnatal growth is important for assessing,
within reference lines, with the exception of individuals predicting and preventing growth problems. As there are
with birth weights below 1000 g. This study shows the many concerns about the unique nutritional conditions of
growth patterns of very low birth weight (VLBW) these newborns and evidence of disparities amongst NICUs
infants in an environment with a high frequency of low in terms of these babies' nutritional functioning, there is
birth weight and growth restriction. It made it possible continuous discussion in connection to defining suitable
for early trophic feeding, a shorter duration of nutritional input for these infants. Additionally, growth
parenteral nutrition, successful abstinence from problems within a single NICU can differ according on the
nutritive enteral feeds, a shorter stay in the hospital, and neonatologists' various philosophies towards commencing
better weight growth in the first few days of life. and progressing nutritional supply. The large configuration

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Volume 8, Issue 3, March – 2023 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
variations amongst NICUs demonstrate the dependency Bangalore between June 2011 and December 2012 were
between nutritional input and growth.() The prevailing prospectively monitored. If first trimester ultrasonography
theory holds that many preterm infants in the NICU suffer was not accessible, the date of the last menstrual period was
from undernourishment. Variable advancement and used to determine the gravid age. Every day up until
prolusion of both parenteral and enteral nutrition lead to discharge, weight was recorded using a computerised
substantial cumulative protein and sugar shortages over importing scale. Length and head circumference (HC)
time, which slow growth during the first few weeks of life. measurements were taken initially over a period of 12 to 24
The most common anthropometric indicator of growth is hours, as well as weekly up until release. Every precaution
weight increase, but over time, changes in length and/or was taken twice, and the average of these compliances was
head circumference provide additional evidence of noted.8
extrauterine growth retardation. Although the definitions of
their ideal nutrition and postnatal growth pattern are still The difference between the minimum weight and the
debatable, the accurate assessment of these babies' postnatal birth weight was used to determine the maximum weight
development is currently of utmost importance. This loss. Calculations were made for the age at which weight
research seeks to describe and validate the growth patterns loss peaks and the amount of time needed to regain
of VLBW babies while they are in the NICU and to identify birthweight. The time from recovering birthweight to
any differences between those born small for gestational age discharge was used as the denominator for the computation
or otherwise. ( AGA or SGA). ( 6) of diurnal weight increase.

II. MATERIALS AND METHODS  Fluid And Dietary Guidelines:

To facilitate physiological weight reduction, 80
 Inclusion Criteria: mL/kg/d of fluid were given to VLBW infants on their first
 All modes of delivery day of life. If the patient's hemodynamics were stable,
 Term gestation or preterm gestation enteral feeds were started as soon as feasible. Mortal milk
 Inborn and outborn was chosen, and Raptakos, Brett & Co.'s Lactodex HMF
was added to boost the calories to 80 kcal per 100 ml and
 Exclusion Criteria: add 0.6 g of fresh protein per kilogramme per day.
 Birth weight greater than or equal to1500 gms Parenteral nutrition (PN) was begun in infants who weren't
 Passing away before medical discharge expected to be on total enteral feeds within the first five
 Transfer to a different facility before being released days of life with a protein input of 3 g/kg/d and a lipid input
 Infants with chromosomal anomalies and major of 1 g/kg on the first day. Based on means and standard
deviations from Fenton's reference data, mean Z scores for
congenital malformations
weight, length, and HC for each gravidity were computed.
 Outborn infants admitted after 24 hours of birth
The cohort was divided into three gravid age groups—less
 Infants who stayed for less than 10 days in the NICU
than 30 weeks, 30-34 weeks, and more than 34 weeks—for
further research. Additionally, the infants were divided into
 Method of Evaluation groups of 250g birthweight intervals and their Ehrenkranz
From delivery until discharge, VLBW infants admitted development angles were combined for comparison.
to the neonatal ferocious care unit at Manipal Hospital in

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Volume 8, Issue 3, March – 2023 International Journal of Innovative Science and Research Technology
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Fig 1 Fatal Infant Growth Chart for Preterm Infants

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Volume 8, Issue 3, March – 2023 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
 Statistical Methods: Pre-test: Test for variance assumption: A test of the
In the current research, descriptive and deducible equality of variance is used to test the assumption of equal
statistical analysis has been done. Results on categorical variances. The test statistic is F with n 1-1 and n2-1 degrees
measures are presented in Number, while those on nonstop of freedom.
measures are displayed on Mean SD(Min- Max).(). Five
positions of significance are used to evaluate relevance. On t-Test: Two-Sample Assuming Unequal Variances
the basis of the information, the following assumptions are
made:

 Dependent variables must have a normal distribution.

 Samples drawn at random from the community must
have independent cases.

The significance of research parameters on a

continuous scale between two groups (inter group analysis)
has been determined using the Student t test (two tailed,
independent). Fisher | Chi-square The significance of
research parameters on a categorical scale between two or
more groups has been determined using an exact test.

 Student t Test (Two Tailed, Independent):

Assumptions: Each subject is divided into one of two
categories at random. The means under comparison have
normal distributions with identical variances.

 Test: The following theories will be compared between

two separate groups:
 Ho: u1 = u2 (means of the two groups are equal)
 Ha: u1 u2 (means of the two group are not equal) Results of the t-test: If the p-value for the t-test is low (
0.05), there is reason to believe that the option is more likely
The test statistic is t, which has n1 plus n2 - 2 degrees than the null hypothesis. In other words, there is proof that
of freedom. N1 and N2 are the sample sizes for groups 1 and the means differ substantially at the p-value-indicated level
2, respectively. If the p-value for this result is low (less than of significance. The null hypothesis cannot be rejected if the
0.05, for instance), there is reason to believe that the p-value for the t-test is greater than 0.05, and you draw the
alternative hypothesis is more likely than the null conclusion that there is sufficient proof to support the
hypothesis. Or, there is evidence that the difference in the equality of the means.
two means are statistically significant.
 Chi-Square Test17:
The test statistic is as follows To ascertain the association between two variables in a
t-Test: Two-Sample Assuming Equal Variances population, use the chi-square test for independence.
Independence here denotes a lack of a connection between
the two elements. In the chi-square test for independence the
degree of freedom is equal to the number of columns in the
table minus one multiplied by the number of rows in the
table minus one

2 
 (Oi  Ei) 2
, Where Oi is Observed frequency and
Ei
Ei is Expected frequency

With (n-1) df

 The Chi-square test's premise

 The following presumptions apply to the chi square test
when it is applied with the common estimate that a chi-
square distribution is appropriate:
 Random sample - A sampling at random of the data from
a community or fixed distribution.

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 Sample size (entire table) - It is believed that the sample This test examines a contingency table that shows how
is sufficiently large. A chi square test will produce an various treatments have resulted in various results. Its null
incorrect inference if it is performed on a population that hypothesis states that the two variables are independent and
is too small. The researcher could make a Type II error that treatments do not impact outcomes. If p is "small,"
by using the chi square test on small groups. reject the null hypothesis and infer that treatment affects
 Expected Cell Count - Sufficient expectations for the outcome.
number of cells. Some call for 5 or more, while others
call for 10 or more. Every cell in a 2-by-2 table should The usual approach to contingency tables is to apply
have a value of 5, and 80% of cells in bigger tables the 2 statistic to each cell of the table. One should probably
should also have a value of 5, but there should be no use the 2 approach, unless you have a special reason. The
cells with a value of 0. Yates' adjustment or the Fisher most common reason to avoid 2 is because you have small
Exact test are used when this presumption is not true. expectation values.

 Fisher Exact Test:

Table 1 Contingency Table

Class1 Class2 Total
Sample1 a b a+b
Sample2 c d c+d
Total a+c b+d N

2x2 Fisher Exact Test statistic= Z-score = (observed value) - (median reference
value).(standard deviation of reference population)

For kids of a certain age, a fixed Z-score suggests a

fixed height or weight difference. A key benefit of Z- score
metamorphosis for population- based operations is that it
enables the computation of the mean and standard deviation
 Fisher Exact test (rxc Tables): for a collection of Z- scores. The average disparity between
the growth measures of the VLBW population and the
standard of the reference population is represented by a
mean Z-score in the unit of standard division.

thus, the change of mean Z- score over age allows us

to assess the change of growth status of VLBW babies over
age during the experimental period. The reference
populations used for the present study was from the Fentons
study.5

 Significant Figures:
of the matrix. Then calculate the conditional probability of
 + Suggestive significance (P value: 0.05<P<0.10)
getting the actual matrix given the particular row and
column sums, given by  Moderately significant ( P value:0.01<P  0.05)
 ** Strongly significant (P value : P0.01)

 Statistical Software:
The Statistical software namely SAS 9.2, SPSS 15.0,
Stata 10.1, MedCalc 9.0.1 ,Systat 12.0 and R environment
ver.2.11.1 were used for the analysis of the data and
which is a multivariate generalization of the hyper Microsoft word and Excel have been used to generate
geometric probability function. graphs, tables etc.

 Z Score: III. OBSERVATION AND RESULTS

A Z-score (standard deviation score) is the difference
between a person's value and the median value of a 91 VLBW babies were eligible at the morning of the
reference population, split by the reference population's study out of which 41 babies were barred because of
standard deviation: various reasons( death, shifted to other sanitorium,), 50
babies were included in the study group( Table 1).8 All the
VLBW babies were divided into AGA and SGA according
to birth weight and enceinte age, out of which AGA
constitute 64 and SGA babies constitute 36( Table 2). The

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Volume 8, Issue 3, March – 2023 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
birth and discharge characteristics and the neonatal ±0.79) which is statistically significant( p = 0.02).15
morbidities of the babies in our study are mentioned in Average weight gain per day in SGA babies is nearly
Table 3 and 4. The mean birth weight of the babies in our similar to AGA babies in all the three groups lower than 1
study was 1180 ± 214gms and the mean enceinte age at kg( SGA-14.04 ±-13.32 ±1.88, P = 0.764), 1 kg –1.25 kg(
admission was30.8 ±2.43 weeks. Average weight at SGA-20.54 ±1.07, AGA-21.55 ±2.39, P = 0.779),1.25 kg-
discharge was 1660 ± 180 gms and average duration of 1.50 kg( SGA-19.83 ±2.50, AGA-23.42 ±2.26, P = 0.361)
sanitorium stay was42.2 ±20.9 days. 72 of the babies in our according to 250 gms birth weight orders( Table 7). There is
study had respiratory torture, 18 of the babies had culture no significant difference in the average proliferation in head
proven sepsis, 16 had feed sectarianism and 10 had habitual circumference and length per week between AGA and SGA
lung complaint, 8 had Necrotising enterocolitis.11, 14 Based babies in all the three groups( p = 0.795 for HC and0.708 for
on the information from Fenton's sources, the mean Z scores length). Maximum weight loss in chance is more in babies
for weight, length, and HC at birth and discharge in all with RDS(8.53 ±0.64) compared to babies without
subjects were calculated.( Table 5). At delivery, the mean Z RDS(5.60 ±1.16) which is statistically significant( p = 0.02)(
scores were individually -1.08, -1.32, and -0.93. These Table 8). There is no significant difference in weight gain
decreased individually by discharge to -2.46, -2.23, and - per day in babies with RDS(19.15 ±1.43) and without
1.33, which is significant (p 0.01). The mean z scores at RDS(20.19 ±1.33)( p = 0.68). There is no significant
birth were significantly lower in SGA babies than in AGA difference in HC and length proliferation between babies
babies for all the parameters, indicating that SGA babies had with and without RDS. There is no significant difference in
considerable intrauterine growth retardation.12 SGA babies the all the growth parameters between babies with sepsis
under 30 weeks have a lower average weight increase per and without sepsis( Table 9). Average weight gain per day is
day than AGA babies (19.06 1.64), but this difference is not lower in babies with NEC(12.58 ±2.11) compared to babies
statistically significant (p = 0.25).( Table 6). There is no without NEC(20.18 ±1.17) which is statistically significant(
significant difference in the average weight gain between p = 0.04) and average weight gain per day is lower in babies
AGA(23.22 ±2.5) and SGA(19.01 ±1.61) babies in the other with feed sectarianism(14.48 ±3.02) to babies without feed
group between 30- 34 weeks( p = 0.216). There is no sectarianism(20.36 ±1.15) which is statistically significant(
significant difference in the average proliferation in head p = 0.05)( Table 10 & 11).18, 19 Postnatal growth of
circumference and length per week between AGA and SGA VLBW babies in our study was superimposed on
babies in all the three groups( p = 0.795 for HC and0.708 for Ehrenkranz reference charts(Fig. 3) for comparision which
length). Maximum weight loss in chances significantly shows that postnatal growth of babies lower than 1250 gms
lower in SGA babies(5.98 ±0.73) compared to AGA is swinging from reference angles with ELBW babies
babies(8.78 ±0.78) which is statistically significant( p = sprucely swinging from the reference angles. The postnatal
0.02) and age to regain birth weight is significantly lower in growth of VLBW babies above 1250 gms was matching the
SGA babies(11.67 ±0.97) compared to AGA babies(14.75 reference growth angles.16

Table 2 Patient Details

DETAILS NO OF NEONATES
TOTAL 91
DEATH 17
SHIFTED TO OTHER HOSPITAL 20
CONGENITAL ANOMALIES 4
STUDY GROUP 50

 Table 2 Classification of Babies Into AGA and SGA

Table 3 According to Gestational Age

Gestation age AGA SGA Total
<30 weeks 16(32.0%) 2(4.0%) 18(36.0%)
30-34 weeks 16(32.0%) 11(22.0%) 27(54.0%)
>34 weeks 0 5(10.0%) 5(10.0%)
Total 32(64.0%) 18(36.0%) 50(100.0%)

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Fig 2 Classification into AGA and SGA According to Gestational Age

Table 4 According to Birth Weight

Birth weight AGA SGA Total
<1 kg 5(10.0%) 6(12.0%) 11(22.0%)
1-1.25kg 12(24.0%) 6(12.0%) 18(36.0%)
1.25-1.50kg 15(30.0%) 6(12.0%) 21(42.0%)
Total 32(64.0%) 18(36.0%) 50(100%)

Fig 3 Classification into AGA and SGA According to Birth Weight

Table 5 Birth and Discharge Characteristics

Parametres Mean
Birth weight 1180 g
Gestational age at birth 30.8 wks
Weight at discharge 1660 g
Age in days at discharge 42.2

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Table 6 Neonatal Morbidity
NEONATAL MORBIDITY AGA (n=32) SGA (n=18) Total (n=50)
RDS 27(84.4%) 9(50%) 36(72%)
AOP 9(28.1%) 3(16.7%) 12(24%)
ANEMIA 1(3.1%) 4(22.2%) 5(10%)
FEED INTOLERANCE 4(12.5%) 4(22.2%) 8(16%)
PDA 8(25%) 2(11.1%) 10(20%)
SEPSIS 6(18.8%) 3(16.7%) 9(18%)
CLD 4(12.5%) 1(5.6%) 5(10%)
CHOLESTASIS 0(0%) 2(11.1%) 2(4%)
UTI 1(3.1%) 1(5.6%) 2(4%)
NEC 1(3.1%) 3(16.7%) 4(8%)

Fig 4 Neonatal Morbidity

Table 7 Mean Z Scores at Birth and Discharge and Comparision between AGA and SGA
Z score AGA( n=32) SGA( n=18) Total( n=50)
Birth weight
 At birth -0.54 -2.03 -1.08
 At Discharge -2.07 -3.16 -2.46
 P value 0.001** 0.001** 0.001**
Length
 At birth -0.55 -2.32 -1.32
 At Discharge -1.64 -3.27 -2.23
 P value 0.001** 0.003** 0.001**
Head circumference
 At birth -0.53 -1.64 -0.93
 At Discharge -1.01 -1.9 -1.33
 P value 0.03* 0.22 0.002**

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Table 8 Comparison of Weight Gain, Max Weight Loss, Age to Regain Birthweight, HC Increment, Length Increment between
AGA and SGA According to Gestational Age of Neonates Studied
Variables <30 weeks 30-34 weeks >34 weeks Total
AGA SGA P AGA SGA P AGA SGA P AGA SGA P
value value value value
Total 16 2 - 16 11 - 0 5 - 32 18 -
number of
babies
Weight gain 19.06± 13.39± 0.250 23.22± 19.01± 0.216 - 18.1± - 21.14± 18.14± 0.178
(gm/day) 1.64 0.16 2.5 1.61 3.1 1.52 1.11

Maximum 10.28± 2.82± 0.063 7.29± 6.28± 0.356 - 6.58± - 8.78± 5.98± 0.021*
weight loss 1.28 0.84 0.76 0.66 4.7 0.78 0.73
(%)
Age to 16.25± 6.5± 0.017* 13.25± 12.27± 0.452 - 12.40± - 14.75± 11.67± 0.020*
regain 1.26 0.5 0.83 0.95 5.7 0.79 0.97
birthweight
(days)
HC 0.69± 0.65± 0.837 0.94± 0.81± 0.145 - 0.96± - 0.81± 0.83± 0.795
increment 0.06 0.15 0.05 0.08 0.31 0.04 0.07
(cm/wk)
Length 0.58± 0.68± 0.290 0.79± 0.63± 0.050* - 0.73± - 0.69± 0.66± 0.708
increment 0.03 0.13 0.05 0.06 0.18 0.03 0.04
(cm/wk)
Results are Mean ± SE

30

25
Weight gain (gm/day)

20

15

10

0
AGA SGA AGA SGA AGA SGA

<30 weeks 30-34 weeks >34 weeks

Fig 5 Average Weight Gain Per Day

14

12
Maximum weight loss (%)

10

0
AGA SGA AGA SGA AGA SGA

<30 weeks 30-34 weeks >34 weeks

Fig 6 Maximum Weight Loss

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20

Age to regain birthweight (days)

18

16

14

12

10

0
AGA SGA AGA SGA AGA SGA

<30 weeks 30-34 weeks >34 weeks

Fig 7 Age in Days to Regain Birth Weight

1.4

1.2
HC increment (cm/wk)

0.8

0.6

0.4

0.2

0
AGA SGA AGA SGA AGA SGA

<30 weeks 30-34 weeks >34 weeks

Fig 8 Increment in Head Circumference Per Week

0.9
Length increment (cm/wk)

0.8

0.7

0.6

0.5

0.4

0.3

0.2

0.1

0
AGA SGA AGA SGA AGA SGA

<30 weeks 30-34 weeks >34 weeks

Fig 9 Increment in Length Per Week

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Table 9 Comparison of Weight Gain, Max Weight Loss, Age to Regain Birth weight, HC Increment, Length Increment between
AGA and SGA According to Birth Weight of Neonates Studied
Variables <1 kg 1.0-1.25kg 1.25-1.50kg Total
AGA SGA P AGA SGA P AGA SGA P AGA SGA P
value value value value
Total 5 6 - 12 6 - 15 6 - 32 18 -
number of
babies
Weight gain 13.32± 14.04± 0.764 21.55± 20.54± 0.779 23.42± 19.83± 0.361 21.14± 18.14± 0.178
(gm/day) 1.88 1.47 2.39 1.07 2.26 2.05 1.52 1.11
Maximum 10.38± 6.12± 0.143 8.05± 5.46± 0.209 8.84± 6.37± 0.228 8.78± 5.98± 0.021*
weight loss 2.58 1.16 1.3 0.98 1.04 1.76 0.78 0.73
(%)
Age to 18.6± 11.33± 0.059+ 13.83± 11.67± 0.311 14.2± 12± 0.237 14.75± 11.67± 0.020*
regain 3.01 1.8 1.28 1.38 0.79 2.11 0.79 0.97
birthweight
(days)
HC 0.61± 0.67± 0.572 0.76± 0.94± 0.160 0.92± 0.88± 0.745 0.81± 0.83± 0.795
increment 0.07 0.08 0.07 0.1 0.05 0.14 0.04 0.07
(cm/wk)
Length 0.55± 0.58± 0.740 0.68± 0.69± 0.862 0.74± 0.72± 0.858 0.69± 0.66± 0.708
increment 0.04 0.07 0.05 0.07 0.06 0.07 0.03 0.04
(cm/wk)

30

25
Weight gain (gm/day)

20

15

10

0
AGA SGA AGA SGA AGA SGA

<1 kg 1.0-1.25kg 1.25-1.50kg

Fig 10 Average Gain in Weight Per Day

25
Age to regain birthweight (days)

20

15

10

0
AGA SGA AGA SGA AGA SGA

<1 kg 1.0-1.25kg 1.25-1.50kg

Fig 11 Age in Days to Regain Birth Weight

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14

12

Maximum weight loss (%)

10

0
AGA SGA AGA SGA AGA SGA

<1 kg 1.0-1.25kg 1.25-1.50kg

Fig 12 Maximum Weight Loss

1.2

1
HC increment (cm/wk)

0.8

0.6

0.4

0.2

0
AGA SGA AGA SGA AGA SGA

<1 kg 1.0-1.25kg 1.25-1.50kg

Fig 13 Increment in Head Circumference Per Week

0.9

0.8
Length increment (cm/wk)

0.7

0.6

0.5

0.4

0.3

0.2

0.1

0
AGA SGA AGA SGA AGA SGA

<1 kg 1.0-1.25kg 1.25-1.50kg

Fig 14 Increment in Length Per Week

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Table 10 Comparision of Growthparamerters in Babies with RDS and Without RDS
Variables AGA SGA Total
With RDS Without P With RDS Without P With RDS Without P
RDS value RDS value RDS value
Total 28 4 - 9 9 - 37 13 -
number of
babies
Weight gain 19.85±1.82 22.61±2.62 0.58 16.97±1.39 19.12±1.49 0.30 19.15±1.43 20.19±1.33 0.68
(gm/day)
Maximum 9.18±0.80 5.97±2.67 0.17 6.52±0.64 5.43±1.31 0.41 8.53±0.64 5.60±1.16 0.02*
weight loss
(%)
Age to 15.07±0.86 12.5±1.71 0.12 10.25±1.20 11.55±1.65 0.22 14.32±0.73 11.84±1.23 0.08
regain
birthweight
(days)
HC 0.66±0.03 0.67±0.13 0.91 0.57±0.04 0.67±0.05 0.13 0.64±0.02 0.67±0.05 0.50
increment
(cm/wk)
Length 0.76±0.04 0.69±0.14 0.55 0.73±0.09 0.66±0.07 0.54 0.75±0.03 0.85±0.07 0.13
increment
(cm/wk)

Table 11 Comparision of Growthparamerters in Babies with Sepsis and without Sepsis

Variables AGA SGA Total
With sepsis Without P With Without P With sepsis Without P
sepsis value sepsis sepsis value sepsis value
Total 6 25 - 3 15 - 9 41 -
number of
babies
Weight gain 20.86±3.68 20.12±1.92 0.86 16.39±3.0 18.37±1.19 0.66 19.37±2.63 19.46±1.27 0.97
(gm/day)
Maximum 8.99±2.55 8.78±0.82 0.91 4.26±1.51 6.32±0.81 0.30 7.41±1.87 7.86±0.62 0.97
weight loss
(%)
Age to 17±3.0 14.36±0.71 0.09 7±0.57 12.73±1.00 0.02 13.66±2.56 13.75±0.58 0.95
regain
birthweight
(days)
HC 0.66±0.08 0.67±0.04 0.91 0.71±0.08 0.60±0.04 0.27 0.68±0.05 0.68±0.02 1.0
increment
(cm/wk)
Length 0.88±0.17 0.78±0.04 0.38 0.76±0.14 0.76±0.06 1.0 0.84±0.11 0.77±0.03 0.39
increment
(cm/wk)

Table 12 Comparision of Growthparamerters in Babies with NEC and without NEC

Variables AGA SGA Total
With Without P With NEC Without P With NEC Without P
NEC NEC value NEC value NEC value
Total 1 31 - 4 14 - 5 45 -
number of
babies
Weight gain 8.31±0 21.58±1.64 - 13.64±2.36 19.30±1.04 0.02* 12.58±2.11 20.18±1.17 0.04*
(gm/day)
Maximum 19.31±0 8.44±0.74 - 5.86±1.83 6.01±0.82 0.93 8.55±3.04 7.69±0.58 0.66
weight loss
(%)

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ISSN No:-2456-2165
Age to 21±0 14.54±0.80 - 9.75±1.93 12.35±1.12 0.28 12±2.70 13.86±0.66 0.39
regain
birthweight
(days)
HC 0.42±0 0.67±0.03 - 0.53±0.12 0.64±0.04 0.27 0.51±0.09 0.66±0.03 0.12
increment
(cm/wk)
Length 0.42±0 0.80±0.04 - 0.63±0.14 0.80±0.06 0.22 0.59±0.11 0.80±0.03 0.35
increment
(cm/wk)

Table 13 Comparision of Growth Paramerters in Babies with Feed Intolerance and without Feed Intolerance
Variables AGA SGA Total
With Feed Without P With Without P With Without P
intolerance Feed value Feed Feed value Feed Feed value
intolerance intolerane intolerance intolerance intolerance
Total number 4 28 - 4 14 - 8 42 -
of babies
Weight gain 12.68±6.12 21.27±1.59 0.08 16.27±1.75 18.55±1.31 0.40 14.48±3.02 20.36±1.15 0.05*
(gm/day)
Maximum 10.55±3.01 8.52±1.55 0.63 6.6±0.87 5.79±0.92 0.66 8.58±1.63 7.62±0.64 0.55
weight loss
(%)
Age to regain 16.5±1.66 14.5±2.83 0.79 15.5±2.10 10.71±0.97 0.03* 16±1.25 13.23±0.71 0.11
birthweight
(days)
HC increment 0.60±0.12 0.67±0.09 0.77 0.49±0.06 0.66±0.04 0.05* 0.55±0.06 0.67±0.03 0.11
(cm/wk)
Length 0.77±0.13 0.79±0.13 0.95 0.65±0.07 0.79±0.07 0.32 0.71±0.07 0.79±0.04 0.41
increment
(cm/wk)

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Fig 14 Postnatal Growth of VLBW Infants Categorized by 250 Gm Birth Weight Superimposed on Ehrenkranz Reference Charts

IV. DISCUSSION Table 3 and 4. The mean birth weight of the babies in our
study was 1180 ± 214gms and the mean enceinte age at
91 VLBW babies were eligible at the morning of the admission was30.8 ±2.43 weeks. Average weight at
study out of which 41 babies were barred because of discharge was 1660 ± 180 gms and average duration of
various reasons( death, shifted to other sanitorium,), 50 sanitorium stay was42.2 ±20.9 days. 72 of the babies in our
babies were included in the study group( Table 1).8 All the study had respiratory torture, 18 of the babies had culture
VLBW babies were divided into AGA and SGA according proven sepsis, 16 had feed sectarianism and 10 had habitual
to birth weight and enceinte age, out of which AGA lung complaint, 8 had Necrotising enterocolitis.11, 14 Based
constitute 64 and SGA babies constitute 36( Table 2). The on the information from Fenton's sources, the mean Z scores
birth and discharge characteristics and the neonatal for weight, length, and HC at birth and discharge in all
morbidities of the babies in our study are mentioned in subjects were calculated.( Table 5). At delivery, the mean Z

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Volume 8, Issue 3, March – 2023 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
scores were individually -1.08, -1.32, and -0.93. These  There is no discernible difference between AGA and
decreased individually by discharge to -2.46, -2.23, and - SGA babies in terms of development haste.
1.33, which is significant (p 0.01). The mean z scores at  Compared to infants without these co-morbidities, babies
birth were significantly lower in SGA babies than in AGA with co-morbidities like NEC and feed dogmatism
babies for all the parameters, indicating that SGA babies had exhibit a substantial decline in growth haste.
considerable intrauterine growth retardation.12 SGA babies  Because of their advanced morbidity, ELBW babies'
under 30 weeks have a lower average weight increase per growth greatly differs from the reference growth maps.
day than AGA babies (19.06 1.64), but this difference is not
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