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Early postnatal growth failure in preterm infants is not inevitable
  1. Edward Thomas Andrews1,
  2. James John Ashton2,3,
  3. Freya Pearson1,
  4. R Mark Beattie2,4,
  5. Mark John Johnson1,4
  1. 1Department of Neonatal Medicine, Princess Anne Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  2. 2Department of Paediatric Gastroenterology, Southampton Children’s Hospital, Southampton, UK
  3. 3Human Genetics and Genomic Medicine, University of Southampton, Southampton, UK
  4. 4National Institute for Health Research, Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
  1. Correspondence to Dr Mark John Johnson, Department of Neonatal Medicine, Princess Anne Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 5YA, UK; m.johnson{at}


Background Previously published data have demonstrated that preterm infants experience a fall across marked centile lines for weight in early life with early poor head growth also reported. This study describes a single neonatal unit’s experience of longitudinal change in weight, head circumference (HC) and length in a cohort of preterm infants born <32 weeks’ gestation.

Methods Data were collected from a single neonatal unit between July 2012 and June 2017. This period followed the introduction of improved nutritional guidelines. Patients were grouped according to their gestational age at birth. Growth lines were constructed for weight, HC and length in each gestational age group from the median measures and compared with reference centile lines.

Results Data were analysed from 396 patients consisting of 2808, 1991 and 2004 measures for weight, HC and length, respectively. Longitudinal growth plots did not show an initial absolute weight loss in any of the subgroups. Across all groups, the mean change in SD score between birth and 36 weeks was −0.27 (95% CI −0.39 to −0.15).

Conclusions This description of longitudinal growth in a cohort of preterm infants demonstrates that early postnatal growth failure is not inevitable, with most infants growing along a trajectory close to their birth centile. There is no evidence of a 2 marked centile line weight decrease or weight loss. These data provide evidence to suggest that extrauterine weight gain tracking centile lines can be achieved.

  • nutrition
  • growth
  • neonatology

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  • Contributors MJJ, RMB, JJA and FP conceptualised and designed the study and reviewed and revised the manuscript. ETA conceptualised and designed the study, performed the data analysis, drafted the initial manuscript, and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding MJJ and RMB are supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre. JJA is funded by an Action Medical Research Training Fellowship. This study was also supported by the European Society for Pediatric Research and National Institute for Health Research.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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