Growth phenotypes of very low birth weight infants for prediction of neonatal outcomes from a Brazilian cohort: comparison with INTERGROWTH

To assess the predictive value of selected growth phenotypes for neonatal morbidity and mortality in preterm infants < 30 weeks and to compare them with INTERGROWTH-21st (IG21). Retrospective analysis of data from the Brazilian Neonatal Research Network (BNRN) database for very low birth weight (...

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Published in:	Jornal de pediatria Vol. 99; no. 1; pp. 86 - 93
Main Authors:	Cardoso, Viviane Cunha, Grandi, Carlos, Silveira, Rita C., Duarte, José Luiz Bandeira, Viana, Maria Cândida Ferrarez Bouzada, Ferreira, Daniela Marques de Lima Mota, Alves, José Mariano Sales, Embrizi, Laís Furlan, Gimenes, Carolina Boschi, de Mello e Silva, Nathalia Moura, Melo, Fernanda Pegoraro de Godoi, Venzon, Paulyne Stadler, Gomez, Dafne Barcala, Vale, Marynéa Silva do, Bentlin, Maria Regina, Barros, Marina Carvalho de Moraes, Cardoso, Laura Emilia Monteiro Bigélli, Diniz, Edna Maria de Albuquerque, Luz, Jorge Hecker, Marba, Sérgio Tadeu Martins, Almeida, João Henrique Carvalho Leme de, Aragon, Davi Casale, Carmona, Fabio
Format:	Journal Article
Language:	English
Published:	Brazil Elsevier Editora Ltda 01-01-2023 Elsevier Sociedade Brasileira de Pediatria
Subjects:	Birth Weight Brazil - epidemiology Female Fetal Growth Retardation Gestational Age Hospital Mortality Humans Infant, Newborn Infant, Premature Infant, Small for Gestational Age Infant, Very Low Birth Weight Network Original Outcome PEDIATRICS Phenotype Predictive values Premature birth Retrospective Studies Very low birth weight Brazil Phenotype Premature birth Very low birth weight Outcome Predictive values Network
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Summary:	To assess the predictive value of selected growth phenotypes for neonatal morbidity and mortality in preterm infants < 30 weeks and to compare them with INTERGROWTH-21st (IG21). Retrospective analysis of data from the Brazilian Neonatal Research Network (BNRN) database for very low birth weight (VLBW) at 20 public tertiary-care university hospitals. Outcome: the composite neonatal morbidity and mortality (CNMM) consisted of in-hospital death, oxygen use at 36 weeks, intraventricular hemorrhage grade 3 or 4, and Bell stage 2 or 3 necrotizing enterocolitis. Selected growth phenotypes: small-for-gestational-age (SGA) defined as being < 3rd (SGA3) or 10th (SGA10) percentiles of BW, and large-for-gestational-age (LGA) as being > 97th percentile of BW. Stunting as being < 3rd percentile of the length and wasting as being < 3rd percentile of BMI. Single and multiple log-binomial regression models were fitted to estimate the relative risks of CNMM, comparing them to IG21. 4,072 infants were included. The adjusted relative risks of CNMM associated with selected growth phenotypes were (BNRN/IG21): 1.45 (0.92–2.31)/1.60 (1.27–2.02) for SGA; 0.90 (0.55–1.47)/1.05 (0.55–1.99) for LGA; 1.65 (1.08–2.51)/1.58 (1.28–1.96) for stunting; and 1.48 (1.02–2.17) for wasting. Agreement between the two references was variable. The growth phenotypes had good specificity (>95%) and positive predictive value (70-90%), with poor sensitivity and low negative predictive value. The BNRN phenotypes at birth differed markedly from the IG21 standard and showed poor accuracy in predicting adverse neonatal outcomes.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0021-7557 1678-4782 1678-4782
DOI:	10.1016/j.jped.2022.07.007