Abstract
Background: Prematurity and neonatal hypotrophy (defined as a Z-score below -2 for weight, length, or head circumference) increase the risk of perinatal morbidity, mortality, and long-term developmental disorders. This study examines the growth trajectories of Moroccan preterm infants and investigates the factors influencing their overall growth outcomes at six months, including weight, length, and head circumference.
Study design: A retrospective longitudinal cohort study.
Methods: The study, conducted at the Rabat National Reference Center for Neonatology and Nutrition (April–October 2023), included 686 premature newborns (24–36 weeks) hospitalized ≥48 hours, with complete anthropometric data and follow-up to six months. Exclusions were major malformations, chromosomal abnormalities, metabolic disorders, or incomplete data. ANOVA and multivariate logistic regression identified independent predictors of weight growth outcomes at six months (WAZ ≥ -2), adjusting for confounders (gestational age, sex, hospitalization, multiparity, phototherapy, antibiotics, early food diversification). Results are reported as odds ratios (OR) with 95% confidence intervals (CI). Growth curves were generated with Python. Significance was set at P<0.05.
Results: Gestational age ≥ 32 weeks (OR = 6.66, 95% CI: 1.21, 36.72; P=0.029) and multiparity (OR = 12.09, 95% CI: 2.12, 68.93; P=0.005) predicted growth outcomes, while hospitalization ≥10 days reduced the likelihood (OR = 0.05, 95% CI: 0.01, 0.27; P=0.001). Male sex and antibiotic use showed non-significant trends (P=0.053).
Conclusions: Close monitoring and targeted nutritional strategies are essential to improve postnatal growth in preterm infants.