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Early energy and protein intakes and associations with growth, BPD, and ROP in extremely preterm infants

Susanna Klevebro1, Vera Westin2, Elisabeth Stoltz Sjöström3

  • 1Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Sachs' Children and Youth Hospital, South General Hospital, Stockholm, Sweden.

Clinical Nutrition (Edinburgh, Scotland)
|June 11, 2018
PubMed

Insights

Early nutrition, including energy and protein, is crucial for extremely preterm infants. Adequate intake can improve growth and reduce the risk of bronchopulmonary dysplasia and retinopathy of prematurity.

Area of Science:

  • Neonatalogy
  • Pediatric Nutrition
  • Critical Care Medicine

Background:

  • Extremely preterm infants experience significant neonatal morbidity.
  • Optimal nutrition is vital for growth and organ development, aiming to decrease late neonatal complications.

Purpose of the Study:

  • To investigate the impact of early nutritional intake on growth.
  • To assess the association between early nutrition and the risks of bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) in high-risk infants.

Main Methods:

  • A population-based cohort study included infants born before 27 0/7 weeks gestational age, surviving at least 10 days, and without severe malformations.
  • Analyzed energy and protein intake on postnatal days 4-6 and its association with weight standard deviation score (WSDS) by day 7.
  • Examined associations between early nutritional intake (days 4-6 and 7-27) and composite outcomes of death/BPD, BPD, and ROP, adjusting for confounders.

Main Results:

  • Each additional 10 kcal/kg/d of energy on days 4-6 correlated with a 0.08 higher WSDS on day 7.
  • Increased energy intake between days 7-27 was linked to a 9% reduced risk of BPD and a 6% reduced risk of ROP.
  • These associations were significant in infants with ≤10 days of mechanical ventilation; in those with >10 days, combined energy and protein intake reduced BPD risk.

Conclusions:

  • Early provision of energy and protein intake is associated with reduced postnatal weight loss.
  • Adequate early nutrition may mitigate the risk of BPD and ROP in extremely preterm infants.
Abstract

Keywords:
Bronchopulmonary dysplasiaExtremely preterm infantGrowthNutritionRetinopathy of prematurity

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