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Nutritional intake and weight z-scores in very low birth weight infants in Peru
Alvaro Proaño1, Romina Elena Aragón2, Fabiola Rivera3
1Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú. Address: Avenida El Polo 740, Edificio C, Oficina 313, Santiago de Surco, Lima, Peru.
Insights
Suboptimal protein intake was observed in very low birth weight infants. However, poor birth weight z-scores, not nutrition, were more strongly linked to negative neonatal outcomes.
Area of Science:
- Neonatalogy
- Pediatric Nutrition
- Growth Monitoring
Background:
- Very low birth weight (VLBW) infants require precise nutritional management for optimal growth and development.
- Understanding nutritional intake and its correlation with neonatal outcomes is crucial for this vulnerable population.
Purpose of the Study:
- To assess the nutritional intake and growth outcomes of VLBW infants during their first postnatal month.
- To identify factors contributing to adverse neonatal outcomes in VLBW infants.
Main Methods:
- A case-series study analyzed medical records of 76 VLBW infants in Lima, Peru (2011-2012).
- Daily fluid, energy, and protein intakes were recorded; weekly weight z-scores were calculated.
- Logistic regression identified predictors of adverse outcomes (mortality or growth restriction) within 28 days.
Main Results:
- Nutritional intakes generally aligned with literature, but protein intake was consistently suboptimal across all four weeks.
- A lower birth weight z-score was significantly associated with adverse neonatal outcomes (p=0.035).
- A birth weight z-score below -1.09 accurately predicted negative outcomes (AUC 96.8%).
Conclusions:
- Protein intake was found to be deficient in the studied VLBW infant population.
- Adverse neonatal outcomes were more strongly associated with a lower birth weight z-score than with nutritional factors.
Objectives:
To determine the actual nutritional intake of very low birth weight infants and their growth outcome during the first month of life. Additionally, we identified factors that account for a negative neonatal outcome in this population.
Methods:
A case-series study was conducted in a tertiary hospital in Lima, Peru between 2011 and 2012 and the data was obtained from medical records. No feeding protocol was used during this study. Daily fluids, energy and protein intakes were documented and weekly weight z-scores were calculated. A logistic regression analysis was used to identify factors for an adverse outcome, defined as neonatal mortality or extra-uterine growth restriction, during the first 28 days of life.
Results:
After applying selection criteria, 76 participants were included. The nutritional intakes were similar to standard values seen in the literature, but protein intakes were suboptimal in all of the four weeks. Birth weight z-score was associated with an adverse outcome (p=0.035). It was determined that having a birth weight z-score under -1.09 predicted a negative outcome with an area under the curve of 96.8% [93.5%, 100%] with a 95% confidence interval.
Conclusion:
Protein intakes are widely deficient in the population of this study. Nevertheless, an adverse outcome during the neonatal period is more associated with a poor birth weight z-score than nutrition-related factors.
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