Early 72-Hour Weight Loss and Short-Term Neonatal Outcomes in Very Low Birth Weight Infants: A Prospective Cohort Study
Year: 2026
Type: preprint
Study design: Observational Study
Abstract: Background: Early postnatal weight loss is an important component of neonatal adaptation and reflects the complex interplay between extracellular fluid contraction, renal maturation, insensible water loss, and fluid management. Although early fluid balance has been associated with neonatal morbidity, the clinical significance of early postnatal weight loss in very low birth weight (VLBW) infants remains incompletely understood, particularly in infants weighing less than 1250 g. Objective To investigate the association between weight loss during the first 72 hours of life and short-term neonatal outcomes in preterm infants with a birth weight below 1250 g. Methods: In this prospective cohort study, preterm infants with birth weights below 1250 g admitted to a tertiary neonatal intensive care unit between February 2023 and February 2024 were enrolled. Infants were categorized according to percentage weight loss during the first 72 hours of life as <5%, 5–10%, and >10%. Maternal and neonatal characteristics, early clinical and laboratory findings, respiratory and cardiovascular outcomes, major neonatal morbidities, and mortality were compared among the three groups. Results: A total of 98 infants were included: 48 (49.0%) had <5% weight loss, 36 (36.7%) had 5–10% weight loss, and 14 (14.3%) had >10% weight loss. Baseline maternal and neonatal characteristics were comparable among the groups. Infants with >10% weight loss received significantly higher cumulative fluid volumes during the first 72 hours (p<0.001), had lower serum creatinine concentrations (p=0.018), and required fewer surfactant doses (p=0.042). No statistically significant differences were observed in respiratory distress syndrome, respiratory support, patent ductus arteriosus, intraventricular hemorrhage, inotropic support, feeding intolerance, early-onset sepsis, or mortality. Nevertheless, infants with >10% weight loss consistently demonstrated numerically lower rates of patent ductus arteriosus, intraventricular hemorrhage, and inotropic support than those with lower degrees of weight loss. Conclusions: Greater early postnatal weight loss during the first 72 hours of life was associated with reduced surfactant requirements without an increase in mortality or major neonatal morbidities. Although statistically significant differences were not observed for patent ductus arteriosus, intraventricular hemorrhage, or inotropic support, all three outcomes demonstrated consistent numerical reductions among infants with greater weight loss. These findings suggest that early postnatal weight loss may represent a clinically useful marker of successful neonatal adaptation rather than an indicator of adverse short-term outcomes. Larger multicenter studies are warranted to validate these findings and to determine the optimal range of early postnatal weight loss in very low birth weight infants.
Source: Research Square
Institutions: Zeynep Kamil Hospital, Sağlık Bilimleri Üniversitesi
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7204274367