Predictive Value of a Multidimensional Neonatal Nutritional Risk Screening Scale for Extrauterine Growth Restriction in Premature Infants

Yumei WU; Juntao ZHANG; Yinghong DENG; Yuqi LI; Huan FENG; Jie WU

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Yumei WU, Juntao ZHANG, Yinghong DENG, Yuqi LI, Huan FENG, Jie WU. Predictive Value of a Multidimensional Neonatal Nutritional Risk Screening Scale for Extrauterine Growth Restriction in Premature Infants[J]. Journal of Kunming Medical University.

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Predictive Value of a Multidimensional Neonatal Nutritional Risk Screening Scale for Extrauterine Growth Restriction in Premature Infants

Department of Pediatrics，The Second Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650101，China

Received Date: 2024-09-01
Available Online: 2025-02-20

Abstract

Abstract

Objective To apply a multidimensional neonatal nutritional risk screening scale for hospitalized premature infants to explore its predictive value for extrauterine growth restriction （EUGR） at the time of discharge. Methods A total of 104 premature infants hospitalized in the neonatal department of the Second Affiliated Hospital of Kunming Medical University from January 2023 to September 2023 were selected as research subjects. Nutritional risk screening was conducted within 24 hours of admission and weekly thereafter using the multidimensional neonatal nutritional risk screening scale. Scoring was based on four dimensions （birth status, weight changes, nutritional intake methods, and disease diagnosis）, with a total score of ≥8 indicating high risk; ≥4 and <8 indicating moderate risk; and <4 indicating low risk. EUGR at the time of discharge was the primary clinical outcome indicator. Receiver operating characteristic （ROC） curves were constructed to explore the predictive value of neonatal nutritional risk screening for EUGR in premature infants. Results At discharge, 40 premature infants （38.5%） experienced EUGR. The nutritional risk screening scores of the EUGR group on day 7 of hospitalization were higher than those of the non-EUGR group （P < 0.05）. The rate of high nutritional risk on day 7 of hospitalization was highest （7.9% in the non-EUGR group, 22% in the EUGR group, and 13.5% overall）. On both day 1 and day 7 of hospitalization, the rate of high nutritional risk in the EUGR group was higher than that in the non-EUGR group （P < 0.05）. There were significant differences in the nutritional risk screening scores on day 7, birth weight Z-scores, discharge corrected gestational age weight Z-scores, and serum albumin levels between the EUGR and non-EUGR groups （P < 0.05）. ROC curves were plotted, yielding AUCs of 0.625 （95%CI 0.514, 0.736）, 0.652 （95%CI 0.544, 0.760）, 0.674 （95%CI 0.561, 0.786）, and 0.641 （95%CI 0.531, 0.750）, indicating certain predictive value. A combined predictive ROC model yielded an AUC of 0.786 （95%CI 0.692, 0.880） for EUGR, which was higher than the AUCs for individual indicators （P < 0.001）. Conclusion The occurrence of EUGR is relatively common among hospitalized premature infants. The nutritional risk is highest during the first week of hospitalization. The multidimensional neonatal nutritional risk screening scale can dynamically assess nutritional risk during hospitalization and may serve as one of the early warning indicators for EUGR in premature infants. The predictive efficacy for EUGR is enhanced when combined with birth weight Z-scores, discharge weight Z-scores, and serum albumin, providing a basis for individualized nutritional management of premature infants.
- Premature infants,
- Extrauterine growth restriction,
- Nutritional risk screening,
- Receiver operating characteristic curve

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