Paper: Determining 6- and 12- Month Growth Outcomes of Infants Born in the United States Weighing Less Than 1000 Grams (19th International Nursing Research Congress Focusing on Evidence-Based Practice)

Monday, 7 July 2008

Alice S. Hill, PhD, FAAN , School of Nursing, The University of Texas Medical Branch at Galveston, Galveston, TX

Learning Objective 1: Describe the prevalence of extremely low birth weight (ELBW) infants in the United States (U.S.) and other developed countries.

Learning Objective 2: Identify the anthropometrics predicted by medical complications, gender, race or socioeconomics in a sample of U.S. ELBW infants (6 and 12 months corrected age).

Background: Over the past two decades the United States (US), similar to other developed countries, experienced a rise in preterm infant birth rates. These rates were lower in most developed countries than in the U.S. Nearly one in ten preterm infants in the U.S. are extremely low-birth-weight (ELBW), born <27 weeks gestation and weighing <1000 grams. The effect preterm birth has on growth underscores the importance of identifying factors that may influence long-term outcomes.

Objective: To assess the growth outcomes of U.S. ELBW infants at 6 and 12 months corrected age based on medical complications at birth, socioeconomic status, race and gender of the infants.

Method: Three hundred charts of ELBW infants were reviewed and a subset of 70 charts was used in this study. Charts were included if infants weighed between 750 and 1000 grams and were between 24-30 weeks gestation at birth. Anthropometrics, bronchopulmonary dysplasia (BPD) diagnosis, socioeconomics (private insurance vs. Medicaid), race and gender data were collected at 6 and 12 months corrected age assessments.

Results: Using binary logistic regression, the odds ratio indicate that ELBW infants at 6 months were more likely to be in the 10th percentile for weight (OR = 5.62, CI .95 = 1.06, 29.88) head circumference (OR = 15.21, CI .95 = 1.62, 14.24) and length (OR = 9.81, CI .95 = 1.83, 52.67) if the infant was on Medicaid vs. private insurance. Infants at 12 months were more likely to be in the 10th percentile for weight if diagnosed with BPD (OR = 5.87, CI .95 = 1.45, 23.65) during hospitalization. There were no significant findings for infants at 6 or 12 months on race or gender.

Conclusions: Socioeconomic status predicts 6 month growth and BPD predicts weight at 12 months. Race and gender did not predict growth in this sample.

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