Risk Factors For Extrauterine Growth Restriction Of Very Low Birth Weight Infants:A Meta-analysis

Objective: To investigate the risk factors for extrauterine growth restriction of very low birth weight infantss,and to provide a reference for the prevention of extrauterine growth restriction of very low birth weight infants.Methods: The databases including China Biomedical Literature Service System,China National Knowledge Infrastructure,Wanfang Data,and Weipu Periodical Database,Pub Med,Web of Science,Embase,Cochrane Library and other databases were searched for studies on the risk factors for extrauterine growth restriction of very low birth weight infants published up to October31,2022.Rev Man 5.4 and Stata 14.1 software were used to perform a meta analysis.Results: A total of 27 studies were included,with 26 case-control studies and 1 cohort study.There were 8209 neonates in total,with 4507 neonates in the case group and 3702 neonates in the control group.The meta analysis showed that risk factors for extrauterine growth restriction of very low birth weight infants include gestational age(OR=3.87,95%CI: 2.51-5.98),birth weight(OR=1.16,95%CI: 1.09-1.23),intrauterine growth retardation(OR=5.36,95%CI: 2.70-10.63),time to initiation of enteral nutrition(OR=3.37,95%CI: 1.96-5.80),time to complete enteral feeding(OR=1.25,95%CI:1.12-1.39),time to return to birth weight(OR=1.68,95%CI:1.08-2.61),small for gestational age(OR=5.64,95%CI: 3.19-9.96),respiratory comorbidity(OR=2.95,95%CI: 1.86-4.69),digestive comorbidity(OR=3.02,95%CI: 1.90-4.80),duration of fasting(OR=1.58,95%CI: 1.01-2.47),amount of amino acids at the end of the first week(OR=1.41,95%CI: 1.23-1.62),and neonatal infection(OR=1.80,95%CI: 1.34-2.42).Conclusions: Factors like low gestational age,low birth weight intrauterine growth restriction,late start of enteral nutrition,long duration of complete enteral feeding,long recovery time of birth weight,small for gestational age,respiratory complications,digestive complications,long fasting time,low amino acid content in the first week,and neonatal infection may increase the risk of extrauterine growth restriction of very low birth weight infants.