{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T10:42:36Z","timestamp":1792406556965,"version":"4.4.0"},"reference-count":38,"publisher":"Walter de Gruyter GmbH","license":[{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpm-2026-0439_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate nutritional status at discharge in VLBW infants using biochemical and composite nutritional indices, and to examine their relationship with extrauterine growth restriction (EUGR; also termed \u201cgrowth faltering\u201d in more recent literature).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2026-0439_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 124 very low birth weight infants (\u226432\u00a0weeks,\u00a0\u22641,500\u202fg) admitted to a tertiary NICU (2021\u20132025). Anthropometric, nutritional, and biochemical parameters were recorded from birth to discharge. Four composite biochemical deficiency outcomes were constructed: protein (CPDO), nutritional (CNDO), mineral\u2013protein (CMPDO), and protein\u2013nitrogen (CPNDO). Multivariable Firth logistic regression and ROC analyses were performed. EUGR was defined cross-sectionally (discharge weight &lt;10th percentile) and longitudinally (weight-for-age Z-score decline &gt;1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2026-0439_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>EUGR occurred in 43.5\u202f% (cross-sectional) and 38.7\u202f% (longitudinal) of infants. Hypouremia (18.0\u202f%) and hypocreatininemia (12.0\u202f%) were the most frequent abnormalities. Composite outcomes were associated with lower gestational age and small-for-gestational-age status. Cross-sectional EUGR was nominally associated with CNDO (aOR 3.72, p=0.023) and CMPDO (aOR 3.96, p=0.031) but not CPDO; given testing across four correlated composite outcomes without formal correction for multiple comparisons, these associations should be regarded as nominal. AUCs for the four composites ranged narrowly from 0.761 to 0.794 and were not formally compared. Anthropometric differences were not significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2026-0439_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Subclinical biochemical deficiency was common at discharge despite non-significant anthropometric differences. Composite biochemical indices showed similar, moderate discriminative performance across definitions; findings are hypothesis-generating and require external, prospective validation before any composite can be considered superior or used clinically.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpm-2026-0439","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T09:55:40Z","timestamp":1792403740000},"source":"Crossref","is-referenced-by-count":0,"title":["Biochemical and anthropometric assessment of nutritional status at discharge in very-low-birth-weight infants: a retrospective cohort study"],"prefix":"10.1515","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8130-7877","authenticated-orcid":false,"given":"Deniz","family":"Yaprak","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology , University of Health Sciences, G\u00fclhane Training and Research Hospital , Ankara , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3728-9613","authenticated-orcid":false,"given":"Belma","family":"Sayg\u0131l\u0131 Karag\u00f6l","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology , University of Health Sciences, G\u00fclhane Training and Research Hospital , Ankara , T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,10,20]]},"reference":[{"key":"2026101909553825199_j_jpm-2026-0439_ref_001","doi-asserted-by":"crossref","unstructured":"Cormack, BE, Embleton, ND, van Goudoever, JB, Hay, WWJr, Bloomfield, FH. 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Defining growth faltering and malnutrition among very preterm infants in a neonatal intensive care unit. J\u00a0Perinatol 2026;46:1649\u20131656. https:\/\/doi.org\/10.1038\/s41372-026-02572-6.","DOI":"10.1038\/s41372-026-02572-6"},{"key":"2026101909553825199_j_jpm-2026-0439_ref_015","doi-asserted-by":"crossref","unstructured":"Fenton, TR, Kim, JH. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatr 2013;13:59. https:\/\/doi.org\/10.1186\/1471-2431-13-59.","DOI":"10.1186\/1471-2431-13-59"},{"key":"2026101909553825199_j_jpm-2026-0439_ref_016","doi-asserted-by":"crossref","unstructured":"Clark, RH, Thomas, P, Peabody, J. Extrauterine growth restriction remains a serious problem in prematurely born neonates. 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A solution to the problem of separation in logistic regression. Stat Med 2002;21:2409\u201319. https:\/\/doi.org\/10.1002\/sim.1047.","DOI":"10.1002\/sim.1047"},{"key":"2026101909553825199_j_jpm-2026-0439_ref_020","doi-asserted-by":"crossref","unstructured":"Liao, WL, Lin, MC, Wang, TM, Chen, CH, Taiwan Premature Infant Follow-up Network. Risk factors for postdischarge growth retardation among very-low-birth-weight infants: a nationwide registry study in Taiwan. Pediatr Neonatol 2019;60:641\u20137. https:\/\/doi.org\/10.1016\/j.pedneo.2019.03.004.","DOI":"10.1016\/j.pedneo.2019.03.004"},{"key":"2026101909553825199_j_jpm-2026-0439_ref_021","doi-asserted-by":"crossref","unstructured":"Lucaccioni, L, Pietrella, E, Malmusi, G, Cinelli, G, Candia, F, Lugli, L, et al.. The burden of extra uterine growth restriction on postnatal growth in very low birth weight preterm newborns. 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N\u00a0Engl J Med 2022;387:1661\u201372. https:\/\/doi.org\/10.1056\/nejmoa2204886.","DOI":"10.1056\/NEJMoa2204886"},{"key":"2026101909553825199_j_jpm-2026-0439_ref_033","doi-asserted-by":"crossref","unstructured":"Wells, N, Stokes, TA, Ottolini, K, Olsen, CH, Spitzer, AR, Hunt, CE. Anthropometric trends from 1997 to 2012 in infants born at\u00a0\u226428\u00a0weeks\u2019 gestation or less. J\u00a0Perinatol 2017;37:521\u20136. https:\/\/doi.org\/10.1038\/jp.2016.244.","DOI":"10.1038\/jp.2016.244"},{"key":"2026101909553825199_j_jpm-2026-0439_ref_034","doi-asserted-by":"crossref","unstructured":"Ziegler, EE. Meeting the nutritional needs of the low-birth-weight infant. Ann Nutr Metab 2011;58:8\u201318. https:\/\/doi.org\/10.1159\/000323381.","DOI":"10.1159\/000323381"},{"key":"2026101909553825199_j_jpm-2026-0439_ref_035","doi-asserted-by":"crossref","unstructured":"Cormack, BE, Jiang, Y, Harding, JE, Crowther, CA, Bloomfield, FH. Relationships between neonatal nutrition and growth to 36\u00a0weeks\u2019 corrected age in ELBW babies-secondary cohort analysis from the provide trial. Nutrients 2020;12:760. https:\/\/doi.org\/10.3390\/nu12030760.","DOI":"10.3390\/nu12030760"},{"key":"2026101909553825199_j_jpm-2026-0439_ref_036","doi-asserted-by":"crossref","unstructured":"Becker, P, Carney, LN, Corkins, MR, Monczka, J, Smith, E, Smith, SE, et al.. Consensus statement of the Academy of Nutrition and Dietetics\/American Society for Parenteral and Enteral Nutrition: indicators recommended for the identification and documentation of pediatric malnutrition (undernutrition). Nutr Clin Pract 2015;30:147\u201361. https:\/\/doi.org\/10.1177\/0884533614557642.","DOI":"10.1177\/0884533614557642"},{"key":"2026101909553825199_j_jpm-2026-0439_ref_037","doi-asserted-by":"crossref","unstructured":"Ramel, SE, Zhang, L, Misra, S, Anderson, CG, Demerath, EW. Do anthropometric measures accurately reflect body composition in preterm infants? Pediatr Obes 2017;12:72\u20137. https:\/\/doi.org\/10.1111\/ijpo.12181.","DOI":"10.1111\/ijpo.12181"},{"key":"2026101909553825199_j_jpm-2026-0439_ref_038","doi-asserted-by":"crossref","unstructured":"Hay, WWJ. Recommended nutrition for preterm infants-on track, but more research is needed. 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