Scholarlink

Background <p>In extremely preterm newborns (ELGANs, &lt; 28&#xa0;weeks’ gestational age [GA]), early weight trajectories reflect fluid balance, yet thresholds for early risk stratification are lacking. We aimed to evaluate whether percentage weight change (ΔW%) from birth weight (BW) and week-1 weight variability were independently associated with death by postnatal day 7 and to identify clinically relevant thresholds.</p> Methods <p>We performed a retrospective single-center secondary analysis of the Golden Week Program (University of Alabama at Birmingham NICU, 2014–2021). Newborns &lt; 28&#xa0;weeks’ GA with BW ≥ 400&#xa0;g and receiving active treatment were included; exclusion criteria were death ≤ 48&#xa0;h, major congenital anomalies, or incomplete weight data. Multivariable logistic regression was performed, adjusted for GA, 5-min Apgar score, and BW <i>z</i>-score; optimal cutoffs were derived using the Youden Index.</p> Results <p>Among 805 neonates, 55 (6.8%) died by day 7. Non-survivors had higher day-3 ΔW% than survivors (median − 5.3% vs. − 10.7%; <i>p</i> &lt; 0.007). Day-3 ΔW% was independently associated with mortality (aOR 1.05; 95% CI 1.02–1.08), with an optimal cutoff of − 6.4% (sensitivity 57%, specificity 72%). Among variability metrics, total fluctuation (mean absolute day-to-day change in ΔW%) showed the best discrimination (aOR 1.45; 95% CI 1.29–1.65; AUC 0.84), with an optimal cutoff of 5.3% (sensitivity 76%, specificity 74%).</p> Conclusions <p>ELGANs who do not lose 5–7% of BW by postnatal day 3 or exhibit an average day-to-day weight fluctuation &gt; 5% of BW are at increased risk of early mortality. These weight-derived metrics may support early risk stratification but require prospective validation.</p> Graphical abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Weight changes and variability in the first week of life: associations with mortality in extremely preterm newborns

  • 期刊论文

  • 发表日期：

    2026年6月3日

查看全文
  • Serena Vigezzi,
  • Elad Resnick,
  • Enrico Vidal,
  • Namasivayam Ambalavanan,
  • Colm P. Travers,
  • David J. Askenazi

摘要

Background

In extremely preterm newborns (ELGANs, < 28 weeks’ gestational age [GA]), early weight trajectories reflect fluid balance, yet thresholds for early risk stratification are lacking. We aimed to evaluate whether percentage weight change (ΔW%) from birth weight (BW) and week-1 weight variability were independently associated with death by postnatal day 7 and to identify clinically relevant thresholds.

Methods

We performed a retrospective single-center secondary analysis of the Golden Week Program (University of Alabama at Birmingham NICU, 2014–2021). Newborns < 28 weeks’ GA with BW ≥ 400 g and receiving active treatment were included; exclusion criteria were death ≤ 48 h, major congenital anomalies, or incomplete weight data. Multivariable logistic regression was performed, adjusted for GA, 5-min Apgar score, and BW z-score; optimal cutoffs were derived using the Youden Index.

Results

Among 805 neonates, 55 (6.8%) died by day 7. Non-survivors had higher day-3 ΔW% than survivors (median − 5.3% vs. − 10.7%; p < 0.007). Day-3 ΔW% was independently associated with mortality (aOR 1.05; 95% CI 1.02–1.08), with an optimal cutoff of − 6.4% (sensitivity 57%, specificity 72%). Among variability metrics, total fluctuation (mean absolute day-to-day change in ΔW%) showed the best discrimination (aOR 1.45; 95% CI 1.29–1.65; AUC 0.84), with an optimal cutoff of 5.3% (sensitivity 76%, specificity 74%).

Conclusions

ELGANs who do not lose 5–7% of BW by postnatal day 3 or exhibit an average day-to-day weight fluctuation > 5% of BW are at increased risk of early mortality. These weight-derived metrics may support early risk stratification but require prospective validation.

Graphical abstract