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Changes in the growth of very preterm infants in England 2006–2018
  1. Aneurin Young1,2,
  2. Tim J Cole3,
  3. Guo Cheng4,
  4. Sarah Ennis4,
  5. R Mark Beattie2,5,
  6. Mark John Johnson1,2
  1. 1 Department of Neonatal Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  2. 2 NIHR Southampton Biomedical Research Centre, Southampton, UK
  3. 3 Population Policy and Practice Programme, UCL, London, UK
  4. 4 Human Genetics and Genomic Medicine, University of Southampton, Southampton, UK
  5. 5 Department of Paediatric Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  1. Correspondence to Dr Aneurin Young, Department of Neonatal Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK; a.young{at}soton.ac.uk

Abstract

Objective To compare weight gain from birth to term equivalent age in very preterm infants in England born during two eras (2006–2011 and 2014–2018); to assess demographic and care factors influencing weight gain.

Methods Data for infants born before 32 weeks of gestation during 2014–2018 in England were obtained (29 687 infants). Weight gain modelled using SuperImposition by Translation And Rotation (SITAR), with infants grouped by gestational week. A cohort from 2006 to 2011 was used for comparison (3288 infants). Multiple linear regression was used to assess factors influencing change in weight SD score from birth to 36 weeks postmenstrual age.

Results Weight gain velocity (termed ‘intensity’ in SITAR models) was greater in the more recent cohort for all gestation groups born before 30 weeks of gestation. After adjustment for gestation, birth weight and other perinatal factors, care elements associated with faster weight gain included delivery in a level 3 unit (0.09 SD less weight gain deficit, 95% CI: 0.07 to 0.10) and parenteral nutrition initiation during the first day of life (0.08 SD, 95% CI: 0.06 to 0.10). Factors associated with slower weight gain included early ventilation (−0.07 SD, 95% CI: −0.08 to −0.05) and less deprived neighbourhood (−0.012 SD per Index of Multiple Deprivation decile, 95% CI: −0.015 to −0.009).

Conclusions Weight gain for extremely preterm infants was faster during 2014–2018 than during 2006–2011. Early initiation of parenteral nutrition and birth in a level 3 unit may contribute to faster weight gain.

  • neonatology
  • growth

Data availability statement

Data may be obtained from a third party and are not publicly available. Data from the NNRD can be acquired for research upon application.

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Data availability statement

Data may be obtained from a third party and are not publicly available. Data from the NNRD can be acquired for research upon application.

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Footnotes

  • Twitter @AneurinYoung, @MarkJohnson800

  • Contributors AY is the guarantor of the study. He contributed to the conception and design of the work, analysed the data and drafted the manuscript. TJC contributed to the conception and design of the work, supported data analysis and revised the manuscript. GC contributed to the analysis of the data. SE, RMB and MJJ contributed to the conception of the work and revised the manuscript.

  • Funding This study was funded by the NIHR Southampton Biomedical Research Centre. AY is supported by a research fellowship issued by the NIHR Southampton Biomedical Research Centre (no grant number supplied).

  • Competing interests AY and MJJ occupy posts supported by the NIHR Southampton Biomedical Research Centre.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.