Growth and biochemical markers of preterm newborns up to six months of corrected age
DOI:
https://doi.org/10.7322/jhgd.138687Palabras clave:
Premature infant, growth, lipids, blood glicose, insulinResumen
Introduction: Due to advances in recent decades in maternal-foetal and neonatal medicine, a greater survival of preterm infants with progressively smaller birth weight and gestational age is observed, increasing the risk of future morbidities on those infants. Among these morbidities, alterations in growth and metabolism are found.
Objective: To analyze the evolution of the growth and the metabolic profile of preterm infants’ cohort from birth at six months of corrected age (CA).
Methods: A descriptive and prospective study with a sample of 107 mothers and 115 preterm infants at birth and 72 preterm infants and 68 mothers at the end of follow-up. Growth (body weight, height, cephalic perimeter) was evaluated at six time points. Plasma concentrations of cholesterol, triglycerides, glucose and insulin of premature infants were assessed during three periods, from birth to 6 months of CA. Comparative analysis of the initial sample and the sample that finished the follow-up was used in chi-square family tests. To Evaluate the growth over the 6-month period by using repeated measurements.
Results: Sociodemographic variables and maternal biochemical profile without statistical differences in the comparison of the mothers of the initial sample with those who completed the follow-up. Linear growth of preterm infants at six months of CA, however without recovery of growth. Plasma concentrations of triglycerides (birth = 48.1, 6 months = 151.1) and cholesterol (birth = 82.7, 6 months = 139.9) increased during the evaluations. Glycaemia remained stable (birth 80.4, 6 months = 83.3) and insulin decreased from 11.0 to 4.2.
Conclusion: Growth of preterm infants, although linear, was lower than expected for age. Lipid profiles presented an ascending curve from birth onward. Therefore, this group is prone to delayed growth and to developing cardiovascular changes throughout life.
Referencias
Harding JE, Derraik JG, Berry MJ, Jaquiery AL, Alsweiler JM, Cormack BE, et al. Optimum feeding and growth in preterm neonates. J Dev Orig Health Dis. 2013;4(3):215-22. DOI: http://dx.doi.org/10.1017/S2040174412000736
Modi M, Saluja S, Kler N, Batra A, Kaur A, Garg P, et al. Growth and neurodevelopmental outcome of VLBW infants at 1 year corrected age. Indian Pediatr. 2013;50(6):573-7. DOI: http://dx.doi.org/10.1007/s13312-013-0170-5
Hernández MI, Mericq V. Metabolic syndrome in children born small-for-gestational age. Arq Bras Endocrinol Metabol. 2011;55(8):583-9. DOI: http://dx.doi.org/10.1590/S0004-27302011000800012
Sassa AH, Higarashi IH, Bercini LO, Arruda DC, Marcon SS. Bebê de risco: acompanhando o crescimento infantil no primeiro ano de vida. Acta Paul Enferm. 2011;24(4):541-9. DOI: http://dx.doi.org/10.1590/S0103-21002011000400015
Farooqi A, Hagglof B, Sedin G, Serenius F. Impact at age 11 years of major neonatal morbidities in children born extremely preterm. Pediatrics. 2011; 127(5):1247-57. DOI: http://dx.doi.org/10.1542/peds.2010-0806
Balci MM, Acikel S, Akdemir R. Low birth weight and increased cardiovascular risk: Fetal programming. Int J Cardiol. 2010;144(1):110-11. DOI: http://dx.doi.org/10.1016/j.ijcard.2008.12.111
Singhal A. Long-term adverse effects of early growth acceleration or catch-up growth. Ann Nutr Metab. 2017;70(3):236-240. DOI: http://dx.doi.org/10.1159/000464302
Coelli AP, Nascimento LR, Mill JG, Molina MCB. Prematuridade como fator de risco para pressão arterial elevada em crianças: uma revisão sistemática. Cad Saúde Pública. 2011; 27(2):207-18. DOI: http://dx.doi.org/10.1590/S0102-311X2011000200002
Parkinson JR, Hyde MJ, Gale C, Santhakumaran S, Modi N. Preterm birth and the metabolic syndrome in adult life: a systematic review and meta-analysis. Pediatrics. 2013;131(4):e1240-63. DOI: http://dx.doi.org/10.1542/peds.2012-2177
Guerrero-Romero F, Aradillas-García C, Simental-Mendia LE, Monreal-Escalante E, de la Cruz Mendoza E, Rodríguez-Moran M. Birth weight, family history of diabetes, and metabolic syndrome in children and adolescents. J Pediatr. 2010;156(5):719-23. DOI: http://dx.doi.org/10.1016/j.jpeds.2009.11.043
Belfort MB, Gillman MW, Buka SL, Mccormick MC. Preterm infant linear growth and adiposity gain: trade-offs for later weight status and intelligence quotient. J Pediatr. 2013;163(6):1564-9. DOI: http://dx.doi.org/10.1016/j.jpeds.2013.06.032
Brown LD, Hay WW. The Nutritional dilemma for preterm infants: how to promote neurocognitive development and linear growth, but reduce the risk of obesity. J Pediatr. 2013;163(6);1543-5. DOI: http://dx.doi.org/10.1016/j.jpeds.2013.07.042
Jaiswal A, Reddy A, Gaddam P, Murki S. Growth and nutritional status at corrected term gestational age in very low birth weight infants. Indian J Pediatr. 2011;78(6):673-8. DOI: http://dx.doi.org/10.1007/s12098-010-0347-z
Statsoft, INC. Programa computacional Statistica 7.0. E.A.U. 2004.
Sociedade Brasileira de Pediatria. Seguimento Ambulatorial do Prematuro de risco. Porto Alegre: Arte e Composição, 2012; p.22-27.
Roberts G, Cheong J, Opie G, Carse E, Davis N, Duff J, et al. Growth of extremely preterm survivors from birth to 18 years of age compared with term controls. Pediatrics. 2013;131(2):e439-45. DOI: http://dx.doi.org/10.1542/peds.2012-1135
Agostoni C, Buonocore G, Carnielli VP, De Curtis M, Darmaun D, Decsi T, et al. Enteral nutrient supply for preterm infants: Commentary from the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2010;50(1):85-91. DOI: http://dx.doi.org/10.1097/MPG.0b013e3181a daee0
Freitas B, Priore S, Lima L, Franceschini S. Extrauterine growth restriction: Universal problem among premature infants. Rev Nutr. 2016;29(1):53-64. DOI: http://dx.doi.org/10.1590/1678-98652016000100006
Committee on Fetus and Newborn, Adamkin DH. Committee on fetus and newborn. Postnatal Glucose Homeostasis in Late-Preterm and Term Infants. Pediatrics. 2011;127(3):575-9. DOI: http://dx.doi.org/10.1542/peds.2010-3851
Van der Lugt NM, Smits-Wintjens VE, van Zwieten PH, Walther FJ. Short and long term outcome of neonatal hyperglycemia in very preterm infants: a retrospective follow-up study. BMC Pediatr. 2010;10:52. DOI: http://dx.doi.org/10.1186/1471-2431-10-52
Sociedade Brasileira de Análises Clínicas (SBAC). Consenso Brasileiro para a normatização da determinação laboratorial do perfil lipídico. [cited 2017 jan 15] Available from: http://www.sbac.org.br/acompanhamento-politico/consenso-brasileiro-para-a-normatizacao-da-determinacao-laboratorial-do-per%EF%AC%81l-lipidico/
Ghaemi S, Najafi R, Kelishadi R. Cord blood lipoprotein profile in term, preterm, and late preterm newborns. J Res Med Sci. 2014;19(11):1038-40.
Ramaraj SM, Bharath AP, Sanjay KM. Lipid profile in neonates and its relation with birth weight and gestational age. Indian J Pediatr. 2015; 82(4):375-7. DOI: http://dx.doi.org/10.1007/s12098-014-1661-7
Rabelo LM. Fatores de risco para doença aterosclerótica na adolescência. J Pediatr. 2001;77(supl. 2):153-64.
Shenoy J, Reddy V, Baliga KN. Serum Lipid Profile in Preterm and Term Appropriate for Gestational Age Indian Newborns: A Hospital Based Comparative Study. J Neonatal Biol. 2014;3 3:156. DOI: http://dx.doi.org/10.4172/2167-0897.1000156
Ikeda N, Shoji H, Murano Y, Mori M, Matsunaga N, Suganuma H, et al. Effects of breastfeeding on the risk factors for metabolic syndrome in preterm infants. J Dev Orig Health Dis. 2014;5(6):459-64. DOI: http://dx.doi.org/10.1017/S2040174414000397
Ehrenkranz RA. Extrauterine growth restriction: is it preventable? J Pediatr. 2014;90(1):1-3. DOI: http://dx.doi.org/10.1016/j.jped.2013.10.003
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