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Parenteral Nutrition in Moderately Preterm, Otherwise Healthy Neonates Is Not Associated With Improved Short-Term
Pavel Prusakov1, Sunday Speaks1, Jacqueline S Magers1
1Department of Pharmacy, Nationwide Children's Hospital, Columbus, Ohio, USA.
Insights
Early parenteral nutrition (PN) did not improve daily weight gain in moderately preterm infants (32-34 weeks gestation). These findings suggest PN supplementation is unlikely to benefit this specific infant population without major comorbidities.
Area of Science:
- Neonatology
- Pediatric Nutrition
- Growth Monitoring
Background:
- Parenteral nutrition (PN) is vital for extremely premature infants at risk of malnutrition.
- Limited data exists on the effects of PN on short-term growth in moderately preterm infants.
Purpose of the Study:
- To investigate the impact of early PN versus standard dextrose-containing fluids (DCFs) on daily weight gain in moderately preterm infants.
- To evaluate secondary outcomes including time to regain birth weight, length of stay, and anthropometric changes.
Main Methods:
- Retrospective cohort analysis of infants born at 32 to <34 weeks gestational age without major comorbidities.
- Comparison of daily weight gain between infants receiving early PN and those receiving DCFs.
- Analysis of secondary outcomes and clinical indicators like necrotizing enterocolitis and antibiotic use.
Main Results:
- No significant difference in mean daily weight gain was observed between the PN and DCF groups (11.8 vs 10 g/kg/d, P = .09).
- Weight gain from nadir to discharge also showed no significant difference (16.8 vs 15.2 g/kg/d, P = .1).
- These results remained consistent even after propensity score matching.
Conclusions:
- Neonates born at ≥32 weeks gestational age without major comorbidities are unlikely to experience benefits from early PN supplementation.
- The study suggests standard care with DCFs may be sufficient for growth in this population.
Background:
Parenteral nutrition (PN) serves a crucial role in providing nutrition to extremely premature infants who are at high risk for malnutrition. However, little is known about the impact of PN on short-term growth outcomes in moderately preterm infants.
Methods:
In this retrospective cohort analysis, patients were included in the study if they were born at ≥32 but <34 weeks gestational age and had no major comorbidities. The primary outcome of this study was to determine whether initiation of early PN for these patients has any effect on daily weight gain compared with standard dextrose-containing fluids (DCFs). Secondary outcomes were to evaluate the differences in time to regain birth weight, length of stay, and change in weight, length, and head circumference percentiles from birth to discharge. Incidence of necrotizing enterocolitis, antibiotic usage, or supplemental oxygen utilization was also evaluated.
Results:
There were 89 patients in the PN group and 35 patients in the DCF group. The mean daily weight gain was not different between PN and DCF groups when calculated from birth to discharge (11.8 vs 10 g/kg/d, respectively; P = .09). There were also no differences when weight gain was calculated from nadir to discharge: 16.8 vs 15.2 g/kg/d, respectively (P = .1). Lack of differences persisted even when propensity matching was performed.
Conclusion:
Based on the study findings, neonates born ≥32 weeks of gestational age without any major comorbidities are unlikely to benefit from PN supplementation.
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