Growth of a cohort of very low birth weight infants in Johannesburg, South Africa

A secondary analysis of a prospective cohort was conducted on 139 VLBW infants (birth weight ≤1500 g) admitted to Charlotte Maxeke Johannesburg Academic Hospital. Growth measurements were obtained from patient files and compared with the World Health Organization Child Growth Standards (WHO-CGS) and with a previous cohort of South African VLBW infants. The sample size per analysis ranged from 11 to 81 infants.Comparison with the WHO-CGS showed initial poor growth followed by gradual catch up growth with mean Z scores of 0.0 at 20 months postmenstrual age for weight, -0.8 at 20 months postmenstrual age for length and 0.0 at 3 months postmenstrual age for head circumference. Growth was comparable with that of a previous cohort of South African VLBW infants in all parameters.Initial poor growth in the study sample was followed by gradual catch up growth but with persistent deficits in length for age at 20 months postmenstrual age relative to healthy term infants.The problem of very low birth weight (VLBW) infants, with their attendant complications, is a significant one. A VLBW (birth weight <1500 g) rate of 3% has been reported at Chris Hani Baragwanath Hospital in Soweto for the years 2000-2002 [1], this compared with 1.43% in the USA [2]. The survival of VLBW infants has improved steadily over the last 50 years which raises a number of management dilemmas, including provision of optimal nutrition and appropriate growth monitoring.Growth monitoring has been shown to be useful and cost effective as a tool in primary health care [3] and is of particular importance in a developing country such as South Africa where there are high rates of malnutrition and VLBW births [4]. Growth monitoring in VLBW infants is, however, complicated by several factors. Firstly, the growth of VLBW infants is characterized by early suboptimal growth followed by a period of catch up growth [5,6]. Secondly, VLBW infants are a heterogeneous group of varying birth weights, sex, gestational ages,