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Nutritional assessment of very low birth weight infants: relationships between anthropometric and biochemical
L E Monteiro Bigélli Cardoso1, M Cícero Falção
1Department of Pediatrics, Medical School, University of São Paulo, Brasil.
Insights
Serum protein mass, not serum levels, is a better indicator for tracking the nutritional status of very low birth weight infants. This finding aids in longitudinal nutritional assessment and improving infant health outcomes.
Area of Science:
- Neonatal nutrition
- Biochemical markers
- Anthropometric assessment
Background:
- Very low birth weight (VLBW) infants require precise nutritional monitoring.
- Traditional anthropometric and serum protein levels may not fully capture nutritional status.
Purpose of the Study:
- To evaluate the utility of biochemical data and its relation to anthropometric data for VLBW infant nutritional assessment.
- To compare serum protein levels versus serum protein mass as nutritional markers.
Main Methods:
- Prospective cohort study of 55 VLBW preterm infants.
- Collected anthropometric (weight, length, circumferences, indices) and biochemical (prealbumin, retinol-binding protein) data at birth, day 14, and day 28.
- Calculated serum protein mass (SPM) for a more accurate nutritional index.
Main Results:
- All measured variables showed significant increases from birth to day 28.
- No significant differences in anthropometric or biochemical data between appropriate and small for gestational age infants.
- Anthropometric measurements did not correlate with serum protein levels, but correlated with serum protein mass (SPM), except for ponderal index.
Conclusions:
- Serum protein mass (SPM) of prealbumin and retinol-binding protein are superior nutritional markers for VLBW infants compared to serum protein levels.
- SPM provides a more accurate assessment of nutritional status in VLBW infants during the neonatal period.
Objective:
Analyze the importance of biochemical data and their relationship with anthropometric data in the longitudinal nutritional assessment of very low birth weight infants.
Methods:
A prospective cohort study was performed on 55 very low birth weight preterm infants (birth weight < 1.500 g and < 37 weeks of gestational age). Measurements of weight, length, head and mid-arm circumferences, mid-arm circumference: head circumference ratio, ponderal index, and body mass index. Serum prealbumin and retinol-binding protein were studied as biochemical parameters. All variables were collected at birth and days 14 and 28 of life.
Results:
The infants presented a mean birth weight of 1,076.7 +/- 286 g and mean gestational age of 30.7 +/- 2.1 weeks. At birth, the mean serum prealbumin was 7.0 +/-1.7 mg/dl and mean retinol-binding protein was 1.3 +/- 0.4 mg/dl. There was a significant increase in all variables studied from birth to day 28. According to nutritional adequacy, there were no differences between appropriate and small for gestational age infants neither in the anthropometric nor in the biochemical data. The anthropometric measurements did not correlate with biochemical parameters. The serum protein concentrations were converted to serum protein mass (SPM) as follows: SPM = serum protein concentration X (100 X weight) X (1- hematocrit)] since the studied proteins are largely intravascular and the protein mass would be a more accurate index of nutritional status. The SPM of both protein and anthropometric parameters were correlated, except for the ponderal index.
Conclusions:
The serum protein mass of the prealbumin and the retinol-binding protein were better nutritional markers in the serial nutritional assessment of very low birth weight infants during neonatal period than the serum protein levels.
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