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Nonrandomised interventional study showed that early aggressive nutrition was effective in reducing postnatal growth
Giulia Genoni1, Marco Binotti2, Alice Monzani1
1Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy.
Insights
Early aggressive nutrition (EAN) significantly reduced extrauterine growth restriction (EUGR) in preterm infants. This nutritional strategy improved weight, head circumference, and length outcomes at discharge.
Area of Science:
- Neonatology
- Pediatric Nutrition
- Growth Monitoring
Background:
- Extrauterine growth restriction (EUGR) is a common complication in preterm infants.
- Optimizing nutritional support is crucial for improving growth outcomes in this vulnerable population.
Purpose of the Study:
- To evaluate the efficacy of an early aggressive nutrition (EAN) strategy in mitigating EUGR among preterm infants.
- To assess the impact of EAN on auxological parameters in preterm neonates.
Main Methods:
- Prospective, nonrandomized interventional study conducted in a neonatal intensive care unit.
- Comparison of EUGR prevalence in 100 preterm infants (gestational age ≤34 weeks) before and after EAN implementation.
- Assessment of weight, head circumference, and length Z-scores and growth velocity.
Main Results:
- Significantly lower EUGR prevalence post-EAN introduction for weight (34% vs. 66%), head circumference (22% vs. 42%), and length (20% vs. 48%).
- Improved Z-scores for all measurements and higher weight velocity in the EAN group.
- Reduced maximum weight loss and negative Z-score changes in the EAN group, particularly in extremely low birthweight infants.
Conclusions:
- Early aggressive nutrition (EAN) effectively reduces EUGR in preterm infants.
- EAN strategy leads to improved auxological outcomes, including better weight gain and linear growth.
- EAN is a beneficial intervention for optimizing growth in preterm neonates.
Aim:
This study evaluated whether an early aggressive nutrition (EAN) strategy could limit extrauterine growth restriction (EUGR) in a cohort of preterm infants.
Methods:
This prospective nonrandomised interventional study was carried out in the neonatal intensive care unit of an Italian hospital from January 2013 to December 2015. The prevalence of EUGR was assessed in 100 infants with a gestational age of ≤34 weeks, 50 after the introduction of an EAN regimen in October 2014 and 50 before.
Results:
The prevalence of EUGR at discharge was significantly lower after the introduction of EAN than before for weight (34% vs. 66%), head circumference (22% vs. 42%) and length at discharge (20% vs. 48%). The Z-scores for all measurements were significantly higher after the introduction of EAN. In the EAN group, weight velocity was significantly higher and maximum weight loss and negative changes in the Z-scores from birth to discharge for weight were lower than in the pre-intervention controls. In extremely low birthweight subjects, the weight Z-score and weight velocity were significantly higher in the EAN group than the control group.
Conclusion:
The use of EAN at a very early age reduced EUGR and improved auxological outcomes in preterm infants.
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