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. 2019 Jun;34(3):436-443.
doi: 10.1002/ncp.10210. Epub 2018 Nov 12.

Analysis of Nutrition Support in Very Low-Birth-Weight Infants With Extrauterine Growth Restriction

Fangwen Hu  1 , Qingya Tang  1   2 , Ying Wang  1 , Jiang Wu  1 , Huijuan Ruan  1 , Lina Lu  1 , Yijing Tao  1 , Wei Cai  1   2
Affiliations

Analysis of Nutrition Support in Very Low-Birth-Weight Infants With Extrauterine Growth Restriction

Fangwen Hu et al. Nutr Clin Pract. 2019 Jun.

Abstract

Objective: To assess the incidence of extrauterine growth restriction (EUGR) in very low-birth-weight infants (VLBWIs) and evaluate the nutrition factors in VLBWIs associated with inadequate nutrient intakes during hospitalization.

Methods: A total of 128 VLBWIs were divided into an EUGR group (n = 87) and a non-EUGR group (n = 41). Growth and parenteral nutrition (PN) and enteral nutrition (EN) practices were analyzed. Actual energy and protein intakes were subtracted from recommended energy (120 kcal/kg/d) and protein (3.75 g/kg/d) intakes, and nutrition deficits were calculated.

Results: Growth restriction was 21.9% at birth and 68.0% at discharge. Compared with established guidelines, PN was started late, and the maximum amino acid intake was low in both groups. EN interruption rate was higher in the EUGR group. The average energy intake in the first day after PN termination was lower in the EUGR group. There were significant differences in actual energy and protein intakes in the 2 groups for several weeks during hospitalization. The cumulative energy and protein deficits were significantly higher in the first 8 weeks and during the third to seventh weeks in the EUGR group, respectively. Step regression analysis showed that there was a significant negative correlation between the cumulative deficit of energy and changes of weight z-scores (r = -0.001, P < .05): as the energy deficit loss increased by 100 kcal, the weight z-scores dropped by 0.1 SD.

Conclusion: Inadequate nutrition intake aggravated the occurrence of EUGR in VLBWIs, especially the energy intake.

Keywords: enteral nutrition; extrauterine growth restriction; growth; infant; nutrition support; parenteral nutrition; very low birth weight infant.

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Figures

Figure 1
Figure 1
Daily energy and protein intakes and sum of percentages of parenteral and enteral energy and protein intakes in EUGR and non‐EUGR groups during hospitalization. Data were analyzed using Student t‐test. aSignificant differences in the total percentage of parenteral and enteral energy accounted for recommendations, respectively, between the 2 groups. bDifferences in daily total energy intakes between the 2 groups. EUGR, extrauterine growth restriction; VLBWI, very low‐birth‐weight infants.
Figure 2
Figure 2
Changes in cumulative nutrient deficits and weight z‐scores during the first 10 weeks of life in EUGR and non‐EUGR groups. Numbers in enclosed brackets indicate sample size at that time point. aSignificant differences between the 2 groups as determined by Student t‐test. #Data were nonnormal presented as quartile. EUGR, extrauterine growth restriction.
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References

    1. Clark RH, Thomas P, Peabody J. Extrauterine growth restriction remains a serious problem in prematurely born neonates. Pediatrics. 2003;111(5 pt 1):986‐990. - PubMed
    1. Agostoni C, Buonocore G, Carnielli VP, et al. Enteral nutrient supply for preterm infants: commentary from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2010;50(1):85‐91. - PubMed
    1. American Academy of Pediatrics Committee on Nutrition . Nutritional needs of low‐birth‐weight infants. Pediatrics. 1985;75(5):976‐986. - PubMed
    1. Thureen PJ. Early aggressive nutrition in the neonate. Pediatr Rev. 1999;20(9):e45‐e55. - PubMed
    1. Koletzko B, Goulet O, Hunt J, et al. 1. Guidelines on Paediatric Parenteral Nutrition of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society for Clinical Nutrition and Metabolism (ESPEN), Supported by the European Society of Paediatric Research (ESPR). J Pediatr Gastroenterol Nutr. 2005;41(suppl 2):S1‐S87. - PubMed

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