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Protein and energy intake and nutritional evolution of preterm infants after hospital discharge: A longitudinal study
Simone Augusta Ribas1, Diana Barbosa Cunha2, Vitor Barreto Paravidino3
1Department of Nutrition in Public Health, Federal University of the State of Rio de Janeiro, Brazil.
Insights
Preterm infants need tailored nutrition plans. Higher energy and protein intake after discharge can improve weight gain in the first year, especially for those with initial deficits.
Area of Science:
- Neonatal nutrition
- Pediatric growth and development
- Nutritional science
Background:
- Preterm infants, particularly those with very low birth weight, face higher risks of nutritional deficiencies and growth issues post-discharge compared to full-term infants.
- Effective nutritional management is crucial for optimizing growth and development in vulnerable preterm populations.
Purpose of the Study:
- To examine the relationship between energy and protein intake and the nutritional status of preterm infants during their first year of corrected age after hospital discharge.
- To identify optimal nutritional strategies for supporting growth in preterm infants.
Main Methods:
- Retrospective longitudinal study involving 131 preterm infants (born <32 weeks gestational age, birth weight <1500 g).
- Growth assessed using z-scores for weight- and length-for-age.
- Energy and protein intake quantified as kcal/kg/day and g/kg/day, analyzed with linear mixed-effect models.
Main Results:
- A majority (62.3%) of infants had an average daily energy intake below 120 kcal/kg.
- Greater weight gain variation was observed in infants with more severe initial nutritional deficits who received intakes exceeding 130 kcal/kg (p=0.02) or 3.5 g protein/kg (p=0.03) by corrected age one year.
- These findings suggest a threshold for beneficial intake.
Conclusions:
- Individualized nutritional plans are essential for preterm infants.
- Continuous monitoring of growth and weight gain is critical for adjusting dietary strategies.
- Optimizing energy and protein intake can mitigate growth restrictions in preterm infants.
Background:
Preterm infants, especially those with very low birth weight, are more susceptible to nutritional deficiencies and growth restriction after hospital discharge than term infants.
Aims:
To investigate the association between energy and protein intake and nutritional evolution of preterm infants during the first year of life of corrected age after hospital discharge.
Study Design:
This is a retrospective longitudinal study with 131 preterm infants born at a high-risk neonatal clinic.
Subjects:
Neonates born at <32 weeks of gestational age and with birth weight < 1500 g were included in the study.
Outcomes Measures:
Growth was assessed by z-scores for weight- and length-to age. Energy and protein intake were assessed by caloric and protein intake rate per kilogram of body weight. Changes in growth were evaluated according to caloric rate and energy intake using linear mixed-effect models.
Results:
We found that most of the followed-up children (62.3%) had an average daily energy intake <120 kcal/kg of body weight. At the end of the first year of life based on corrected age, the variation in weight gain was greater among those with more severe nutritional deficit at born and who had daily intakes over 130 kcal/kg of body weight (p=0.02) or over 3.5 g of protein/kg of body weight (p=0.03).
Conclusion:
Individualized dietary plans for preterm infants should be based on the continuous assessment of growth and weight gain.
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