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Related Experiment Video

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Development of a Neonatal Piglet Acute Lung Injury Model Recreating the Early Environment of Preterm Infant Lungs
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Improved nutrition for extremely preterm infants - A population based observational study.

Vera Westin1, Susanna Klevebro2, Magnus Domellöf3

  • 1Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Function Area Clinical Nutrition, Karolinska University Hospital, Stockholm, Sweden.

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|February 21, 2018
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Summary

Nutritional support for extremely preterm infants improved significantly in Stockholm between 2004-2011, with increased energy and protein intake leading to better growth. However, many infants still did not reach recommended intake levels.

Keywords:
EnergyEnteral nutritionParenteral nutritionPreterm infantProtein

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Area of Science:

  • Neonatology
  • Pediatric Nutrition
  • Intensive Care Medicine

Background:

  • Extremely preterm (EPT) infants (<27 weeks gestational age) face high malnutrition risks in neonatal intensive care units (NICUs).
  • Nutritional deficits and growth faltering are common challenges during NICU treatment for EPT infants.
  • Optimizing nutritional strategies is crucial for EPT infant health and long-term development.

Purpose of the Study:

  • To evaluate changes in nutritional intake over the first 56 postnatal days in EPT infants.
  • To assess trends in energy and protein intake during NICU treatment.
  • To analyze the impact of nutritional interventions on growth in EPT infants.

Main Methods:

  • Retrospective analysis of nutrition and growth data from hospital records of 316 EPT infants born between 2004-2011 in Stockholm.
  • Daily enteral and parenteral nutrient intake data collected for the first 28 postnatal days, and on specific later days (35, 42, 49, 56).
  • Population-based study approach to evaluate changes over an 8-year period.

Main Results:

  • Median energy intake increased from 77 to 98 kcal/kg/d and protein intake from 2.4 to 3.6 g/kg/d between 2004-2005 and 2010-2011.
  • Continuous increases in energy and protein intake were observed during the first week (postnatal days 0-6) over the study period.
  • Earlier achievement of full enteral feeds and a higher proportion of enteral feeds in the first week were noted in later years, correlating with improved growth.

Conclusions:

  • Neonatal nutrition significantly improved in Stockholm from 2004 to 2011, with earlier and higher parenteral nutrition provision.
  • Despite improvements, many EPT infants did not achieve recommended macronutrient intake levels by the study's end.
  • A significant improvement in infant weight gain was observed when comparing the 2004-2005 period to subsequent years (2006-2011).