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Published on: December 20, 2011
Analysis of Nutrition Support in Very Low-Birth-Weight Infants With Extrauterine Growth Restriction
Fangwen Hu1, Qingya Tang1,2, Ying Wang1
1Department of Clinical Nutrition, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
Inadequate nutrition, particularly energy intake, worsens extrauterine growth restriction (EUGR) in very low-birth-weight infants (VLBWIs). Addressing nutrient deficits during hospitalization is crucial for improving growth outcomes in these vulnerable infants.
Area of Science:
- Neonatalogy
- Pediatric Nutrition
- Growth Monitoring
Background:
- Extrauterine growth restriction (EUGR) is a significant concern in very low-birth-weight infants (VLBWIs).
- Optimizing nutritional support during hospitalization is critical for VLBWIs to achieve appropriate growth.
- Understanding the relationship between nutrient intake and EUGR is essential for clinical practice.
Purpose of the Study:
- To determine the incidence of EUGR in VLBWIs.
- To identify nutritional factors associated with inadequate nutrient intake during hospitalization in VLBWIs.
- To evaluate the impact of nutrient deficits on growth outcomes.
Main Methods:
- A cohort of 128 VLBWIs was divided into EUGR and non-EUGR groups.
- Growth parameters, parenteral nutrition (PN), and enteral nutrition (EN) practices were analyzed.
- Nutrient deficits were calculated by comparing actual intake to recommended energy and protein levels.
Main Results:
- The incidence of growth restriction increased from 21.9% at birth to 68.0% at discharge.
- VLBWIs in the EUGR group experienced higher rates of EN interruption and lower energy intake post-PN.
- Cumulative energy and protein deficits were significantly higher in the EUGR group, correlating negatively with weight z-score changes.
Conclusions:
- Inadequate nutrient intake, especially energy, significantly contributes to the development of EUGR in VLBWIs.
- Timely initiation and adequate provision of PN and EN are vital.
- Reducing nutrient deficits during hospitalization can mitigate EUGR in VLBWIs.
Objective:
To assess the incidence of extrauterine growth restriction (EUGR) in very low-birth-weight infants (VLBWIs) and evaluate the nutrition factors in VLBWIs associated with inadequate nutrient intakes during hospitalization.
Methods:
A total of 128 VLBWIs were divided into an EUGR group (n = 87) and a non-EUGR group (n = 41). Growth and parenteral nutrition (PN) and enteral nutrition (EN) practices were analyzed. Actual energy and protein intakes were subtracted from recommended energy (120 kcal/kg/d) and protein (3.75 g/kg/d) intakes, and nutrition deficits were calculated.
Results:
Growth restriction was 21.9% at birth and 68.0% at discharge. Compared with established guidelines, PN was started late, and the maximum amino acid intake was low in both groups. EN interruption rate was higher in the EUGR group. The average energy intake in the first day after PN termination was lower in the EUGR group. There were significant differences in actual energy and protein intakes in the 2 groups for several weeks during hospitalization. The cumulative energy and protein deficits were significantly higher in the first 8 weeks and during the third to seventh weeks in the EUGR group, respectively. Step regression analysis showed that there was a significant negative correlation between the cumulative deficit of energy and changes of weight z-scores (r = -0.001, P < .05): as the energy deficit loss increased by 100 kcal, the weight z-scores dropped by 0.1 SD.
Conclusion:
Inadequate nutrition intake aggravated the occurrence of EUGR in VLBWIs, especially the energy intake.
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