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Estimation of Fat-free Mass at Discharge in Preterm Infants Fed With Optimized Feeding Regimen
Julie Larcade1, Pierre Pradat, Rachel Buffin
1*Neonatology, Croix Rousse Hospital †Centre for Clinical Research, University Hospital Croix Rousse, Hospices Civils de Lyon, Lyon ‡Lyon-Sud Charles Merieux Medical School, Claude Bernard University Lyon 1 §Rhone-Alpes Human Nutrition Research Center, Pierre Benite, France.
Insights
A new equation accurately estimates infant fat-free mass (FFM) in preterm infants at discharge. This validated method improves upon previous estimations for modern neonatal care practices.
Area of Science:
- Neonatal Medicine
- Pediatric Nutrition
- Body Composition Analysis
Background:
- Accurate assessment of infant fat-free mass (FFM) is crucial for monitoring growth and nutritional status in preterm infants.
- Existing equations for estimating FFM at discharge may not reflect current neonatal intensive care and feeding practices.
Purpose of the Study:
- To validate a previously developed equation (E1) for estimating FFM in preterm infants at discharge.
- To develop and propose a new, more accurate equation for FFM estimation in this population.
Main Methods:
- A cohort of 155 preterm infants (born before 33 weeks gestation) was studied.
- Fat-free mass (FFM) was measured at discharge using air displacement plethysmography (PEA POD).
- FFM estimates from equation E1 were compared to PEA POD measurements; a new regression model was developed.
Main Results:
- Equation E1 showed a strong correlation with PEA POD (r=0.939) but systematically underestimated FFM.
- The underestimation by E1 increased with higher FFM values.
- The newly proposed equation demonstrated improved accuracy (r=0.950) with minimal average difference (-12 g).
Conclusions:
- Previous FFM estimation methods require adaptation for contemporary preterm infant populations.
- The newly developed equation provides a more accurate assessment of FFM at discharge for infants receiving optimized nutrition.
- Accurate FFM estimation is essential for optimizing care in modern neonatal units.
Objectives:
The purpose of the present study was to validate a previously calculated equation (E1) that estimates infant fat-free mass (FFM) at discharge using data from a population of preterm infants receiving an optimized feeding regimen.
Methods:
Preterm infants born before 33 weeks of gestation between April 2014 and November 2015 in the tertiary care unit of Croix-Rousse Hospital in Lyon, France, were included in the study. At discharge, FFM was assessed by air displacement plethysmography (PEA POD) and was compared with FFM estimated by E1. FFM was estimated using a multiple linear regression model.
Results:
Data on 155 preterm infants were collected. There was a strong correlation between the FFM estimated by E1 and FFM assessed by the PEA POD (r = 0.939). E1, however, underestimated the FFM (average difference: -197 g), and this underestimation increased as FFM increased. A new, more predictive equation is proposed (r = 0.950, average difference: -12 g).
Conclusions:
Although previous estimation methods were useful for estimating FFM at discharge, an equation adapted to present populations of preterm infants with "modern" neonatal care and nutritional practices is required for accuracy.
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