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Energy intake, growth, and development in ventilated very-low-birth-weight infants with and without bronchopulmonary
S Davidson1, A Schrayer, E Wielunsky
1Department of Neonatology and Follow-up Clinic, Beilinson Medical Center, Sackler School of Medicine, Petah Tiqva, Israel.
Insights
Growth delay affects ventilated very-low-birth-weight infants with and without bronchopulmonary dysplasia. Aggressive nutritional support for growth may not improve neurodevelopmental outcomes in these infants.
Area of Science:
- Neonatology
- Pediatric Nutrition
- Developmental Pediatrics
Background:
- Very-low-birth-weight (VLBW) infants often experience growth delay and are at risk for bronchopulmonary dysplasia (BPD).
- Neurodevelopmental outcomes in VLBW infants are influenced by various factors, including nutrition and growth.
- The relationship between nutritional support, growth, and neurodevelopmental outcomes in VLBW infants with BPD remains an area of investigation.
Purpose of the Study:
- To compare growth achievements in ventilated VLBW infants with and without BPD.
- To determine the association between neurodevelopmental outcome, growth parameters, and nutritional intake.
- To investigate the impact of nutritional support on neurodevelopmental outcomes in VLBW infants.
Main Methods:
- Study included 71 ventilated VLBW infants (500-1250 g), categorized with (n=30) and without (n=41) BPD.
- Growth parameters (weight, length, head circumference) and nutritional intake (energy intake, age to regain birth weight, age to full gavage feeds) were assessed.
- Neurodevelopmental outcomes were evaluated at 12 and 21 months corrected age, with handicaps categorized as minor or major.
Main Results:
- Growth delay was present in both groups; no significant association found between head circumference and weight loss, age to full feeds, or energy intake at 2 and 4 weeks.
- Infants with BPD had a higher incidence of handicaps (50%) compared to controls (37%).
- Handicapped infants required significantly longer assisted ventilation (21.5 vs 12.5 days). Lower mean energy intake at 2 weeks was observed in handicapped infants (344.82 vs 412.86 kJ/kg/day), but other growth and nutritional parameters did not differ significantly.
Conclusions:
- Aggressive nutritional support aimed at promoting growth in ventilated VLBW infants may not significantly influence neurodevelopmental outcomes.
- No association was found between abnormal neurodevelopmental outcomes and anthropometric measurements at 12 and 21 months corrected age.
- While nutritional intake at 2 weeks was lower in handicapped infants, overall growth and nutritional recovery did not significantly differ between normal and handicapped infants.
Abstract:
Seventy-one ventilated very-low-birth-weight infants (birth weight, 500 to 1250 g) with (n = 30) and without (n = 41) bronchopulmonary dysplasia were studied to compare their growth achievements and to determine the association between neurodevelopmental outcome, growth, and nutrition. Growth delay was observed in both groups. No association was found between head circumference and percent weight loss, age to full gavage feeds, age to regain birth weight and energy intake at 2 and 4 weeks of life. Fifty percent of infants with bronchopulmonary dysplasia and 37% of the control group had minor and major handicap. Mean duration of assisted ventilation was significantly longer in handicapped infants (21.5 vs 12.5 days; F = 6.49; df = 1,53). No association was found between abnormal neurodevelopmental outcome and weight, length, and head circumference at 12 and 21 months after term. Although mean energy intake per kilogram per day at 2 weeks of life was significantly lower in handicapped infants (344.82 vs 412.86 kJ; F = 7.6; df = 1,53), age to regain birth weight, age to full feeds, percent weight loss, and energy intake at 4, 6, and 8 weeks of life did not differ significantly between normal and handicapped infants. Aggressive nutritional support to promote growth in ventilated very-low-birth-weight infants may not influence the neurodevelopmental outcome.