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Feeding tolerance of preterm infants appropriate for gestational age (AGA) as compared to those small for gestational

Valentina Bozzetti1, Giuseppe Paterlini, Paola DeLorenzo

  • 1Neonatal Intensive Care Unit, MBBM Foundation, San Gerardo Hospital.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|November 8, 2012
PubMed

Insights

Small for gestational age (SGA) preterm infants experience delayed full enteral feeding compared to adequate for gestational age (AGA) infants. Antenatal steroids improve feeding tolerance in both groups.

Area of Science:

  • Neonatalogy
  • Perinatal Medicine
  • Pediatric Gastroenterology

Background:

  • Preterm infants often face prolonged enteral fasting due to perceived instability, increasing complication risks.
  • Feeding tolerance is crucial for preterm infant development and requires timely achievement of full enteral feeding (FEF).

Purpose of the Study:

  • To compare feeding tolerance between adequate for gestational age (AGA) and small for gestational age (SGA) preterm infants.
  • To identify perinatal factors influencing the time to achieve full enteral feeding (FEF) in preterm infants.

Main Methods:

  • Retrospective analysis of 310 inborn infants with gestational age (GA) less than 32 weeks (Jan 2006-Dec 2010).
  • Evaluation of time to FEF and its association with infant size (AGA vs. SGA) and various perinatal factors.

Main Results:

  • SGA infants required longer time to FEF compared to AGA infants.
  • Increased GA and antenatal steroid administration were associated with reduced time to FEF.
  • Factors prolonging time to FEF included low Apgar score, inotropes, caffeine, sepsis, necrotizing enterocolitis (NEC), and patent ductus arteriosus (PDA).
  • Multivariate analysis confirmed GA, antenatal steroids, SGA status, and NEC as independent predictors of time to FEF.

Conclusions:

  • Gestational age and SGA status significantly impact feeding tolerance in preterm infants.
  • Antenatal betamethasone effectively reduces the time to achieve full enteral feeding in both AGA and SGA infants.
  • Identifying and managing risk factors like NEC is crucial for optimizing enteral feeding in preterm neonates.

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