Weight gain velocity and adequate amount of nutrition for infants with congenital diaphragmatic hernia
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In brief
In brief
Multicenter study of 98 neonates with isolated CDH shows catch-up growth begins at 2 months of age, requiring >122 kcal/kg/day in severe cases to prevent weight Z-score decline. Findings provide evidence-based nutritional targets for managing growth retardation in this population.
Written by the GCMD Library team from the article.
Abstract
Purpose
Growth retardation is a severe morbidity in infants with congenital diaphragmatic hernia (CDH). This study aimed to determine when catch-up growth starts in infants with CDH and to determine the adequate amount of nutrition required during catch-up growth.
Methods
This was a multicenter retrospective cohort study involving neonates with isolated CDH (born 2006–2010; n = 98). Weight gain velocity (WGV) was calculated using body weight Z-scores. The minimum required weight gain was defined as WGV ≥ 0. Patients were dichotomized into severe and non-severe cases according to diaphragmatic defects.
Results
Average monthly WGV changed from < 0 to ≥ 0 at 2 months of age. Total caloric intake at 2 months of age was lower when the WGV between 1 and 3 months was < 0 in both severe cases [122 (95% confidence interval (CI) 116–128) vs. 97 (95% CI 84–110) kcal/kg/day, p = 0.02] and non-severe cases [115 (95% CI 110–120) vs. 99 (95% CI 87–111) kcal/kg/day, p < 0.001)].
Conclusion
Catch-up growth started at approximately 2 months of age. During this period, total caloric intake of > 122 kcal/kg/day was needed to avoid decreases in the body weight Z-score in severe cases.