ArticlePediatrics2025
Improving and Sustaining VLBW Infant Growth Through a Quality Collaborative in California.
Article in Pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- A quality improvement approach to growth in moderate and late preterm infants in small NICUs.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Early enteral nutrition practices and their association with growth and necrotising enterocolitis in extremely preterm infants-A dual national cohort study.Pediatric research · 2026Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionVery low birth weight (VLBW) infants experience inadequate postnatal growth, which may be associated with poor neurodevelopmental outcomes. This statewide quality improvement collaborative aimed to improve VLBW infant growth.
methodsThe collaborative was conducted from October 2018 to March 2020. The aim was to reduce the primary outcome measure of proportion of weight <10th percentile at discharge among VLBW infants by 20% in 1 year. The secondary outcome measure was a z-score deficit ≥0.8 from birth. Process measures were early fortification, nutrition rounds, and feeding guideline compliance. Balancing measures were necrotizing enterocolitis and human milk feeding at discharge. Measures were analyzed with statistical process control charts. Outcome measures were compared among participant and nonparticipant neonatal intensive care units (NICUs) for a total of 6 years including 2 years after the collaborative.
results22 NICUs participated in the collaborative. The 78-month analysis included 7856 VLBW infants. The participant group reduced growth restriction at discharge (45% to 37.6%) and z-score deficit ≥0.8 (44.4% to 33.3%). Postcollaborative improvement was sustained for 24 months. The 114 nonparticipant NICUs did not reduce rates of growth outcome measures. Several process measures showed sustained improvement. Balancing measures were unchanged during the collaborative period. However, post hoc analysis showed a higher necrotizing enterocolitis rate when 2 years after the collaborative were included.
conclusionQuality improvement collaborative NICUs improved nutrition processes and VLBW growth. Improvement was sustained for 24 months after the collaborative. Nonparticipant NICUs did not show similar improvement. Implementing NICU nutrition processes may lead to sustained improvements in VLBW infant growth.
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