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Randomized Controlled Trial
. 2023 Mar 4;15(5):1279.
doi: 10.3390/nu15051279.

Delayed Macronutrients' Target Achievement in Parenteral Nutrition Reduces the Risk of Hyperglycemia in Preterm Newborn: A Randomized Controlled Trial

Maria Di Chiara  1 , Gianluigi Laccetta  1 , Daniela Regoli  1 , Lucia Dito  1 , Caterina Spiriti  1 , Benedetta De Santis  1 , Elisa Travaglia  1 , Rita Prota  1 , Pasquale Parisi  2 , Roberto Brunelli  1 , Giovanni Boscarino  1 , Gianluca Terrin  1
Affiliations
Randomized Controlled Trial

Delayed Macronutrients' Target Achievement in Parenteral Nutrition Reduces the Risk of Hyperglycemia in Preterm Newborn: A Randomized Controlled Trial

Maria Di Chiara et al. Nutrients. .

Abstract

Hyperglycemia (HG) is an independent risk factor of mortality and morbidity in very low birth weight newborns (VLBW). Achievement of high nutritional intakes in the first days of life (DoL) by parenteral nutrition (PN) increases the risk of HG. We aim to assess if a delayed achievement of the PN macronutrient target dose could reduce the occurrence of HG in VLBW. We enrolled 353 VLBW neonates in a randomized controlled clinical trial comparing two PN protocols that differed in the timing of energy and amino acid target dose achievement: (1) early target dose achievement (energy within 4-5 DoL; amino acids within 3-4 DoL) vs. (2) late target dose achievement (energy within 10-12 DoL; amino acids within 5-7 DoL). The primary outcome was the occurrence of HG during the first week of life. An additional endpoint was long-term body growth. We observed a significant difference in the rate of HG between the two groups (30.7% vs. 12.2%, p = 0.003). Significant differences were observed in terms of body growth at 12 months of life between the two groups (weight Z-Score: -0.86 vs. 0.22, p = 0.025; length: -1.29 vs. 0.55, p < 0.001). Delayed achievement of energy and amino acid intake may be useful to reduce the risk of HG along with an increase of growth parameters in VLBW neonates.

Keywords: EUGR; VLBW; amino acids; energy; growth; intake; neonates.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Screening and randomization.
Figure 2
Figure 2
Macronutrient intake administered through PN during the first week of life. Figure legend: * p-value < 0.05.
Figure 3
Figure 3
Rate of occurrence of hyperglycemia in the two study groups during the first week of life.
See this image and copyright information in PMC

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