Early Discharge of Very Preterm Infants Is Not Associated with Impaired Growth up to Three Months Postmenstrual Age: A Prospective Cohort Study

TL;DR

Early discharge of very preterm infants under a family-centered care program does not negatively affect their growth up to three months postmenstrual age.

Contribution

Demonstrates that early discharge of preterm infants does not impair growth outcomes when implemented under family-centered care.

Findings

PMA at discharge decreased significantly in the intervention cohort compared to the baseline.

No significant differences in growth outcomes were observed at term-equivalent age or three months PMA.

Z-Scores for weight, length, and head circumference did not differ significantly between cohorts at three months PMA.

Abstract

Background/Objectives: Postnatal growth restriction and duration of hospital stay have been identified as risk factors for adverse neurodevelopment in preterm infants. Implementation of a family-centered care (FCC) program in our institution reduced length of stay in preterm infants. This study evaluates the effect of more early discharge on growth up to three months postmenstrual age (PMA). Methods: We conducted a prospective, single-center cohort study in a German level III neonatal unit (October 2020–November 2023) including six consecutive cohorts (n = 184) with progressive FCC implementation. This secondary analysis examined growth at discharge, term-equivalent age (TEA), and three months PMA. Results: PMA at discharge significantly decreased from the baseline to intervention cohort 5 (37.8 ± 2.1 vs. 35.7 ± 0.91 weeks PMA; p = 0.03). Compared to the baseline cohort, infants in intervention cohort 5 had significantly lower weight, length, and head circumference at discharge. However corresponding Z-Scores did not differ significantly between the cohorts. No significant differences in growth outcomes were observed at TEA or at three months PMA. Furthermore, there were no significant differences in the change in Z-Score for weight, length, and HC from birth to three months PMA. Conclusions: Early discharge under FCC did not impair growth to three months PMA, suggesting that early discharge is a safe practice with respect to growth outcomes in preterm infants. Further randomized multicenter studies are needed to confirm these results.