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Found 1 result

  1. It is not uncommon to have extreme preterm babies being under weight and stunted at 36 or 40 weeks PMA. Our standard of care for postnatal nutrition has traditionally been to provide nutrients which matches fetal accretion rate. But is it really wise to give the same quantity of nutrients. Preterm birth and exposure to postnatal life in itself would cause epigenetic changes in how a neonate shoudl. Metabolize and assimilate the nutrients administered. So what really constitutes as EUGR. Is it only the 10 th centile at 36 weeks and 40 weeks PMA or is it standard deviation scores below expected (like 1SD below the 10 th centile - considering that some amount of postnatal growth restriction is acceptable and expected due to the loss in the first 2 weeks ) For us its a complex issue of allowing the neonates to grow at their own centile (even below the 3 rd centile) as providing excess nutrition for catchup might result in more fat mass instead of fat free mass. (ultimate goal being adequate and appropriate body composition, linear and mass growth) On a bigger picture the question that needs to be answered is - Should EUGR be determined by a statistical definition alone based on anthropometric parameters OR should it be based on the adverse body composition analysis and neurodevelopmental outcomes at a prespecified time (which is obviously more difficult)
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