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The glucose infusion rate of parenteral nutrition in the first week of life in preterm infants: an observational

Dina Angelika1,2, Risa Etika3, Martono Tri Utomo2

  • 1Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

Italian Journal of Pediatrics
|November 5, 2021
PubMed

Insights

Lower glucose infusion rates (GIR) in parenteral nutrition for preterm infants increased hypoglycemia risk but decreased sepsis risk. Higher GIR did not increase mortality, but respiratory distress syndrome (RDS) was a mortality risk factor.

Area of Science:

  • Neonatology
  • Pediatric Endocrinology
  • Clinical Nutrition

Background:

  • Preterm infants often require continuous glucose infusion post-birth due to interrupted transplacental glucose supply.
  • Optimizing glucose infusion is crucial for neurodevelopmental outcomes in neonates.

Purpose of the Study:

  • To investigate the effect of varying glucose infusion rates (GIR) in parenteral nutrition (PN) during the first week of life on neonatal morbidity and mortality in preterm infants.
  • To identify specific neonatal morbidities and mortality risks associated with different GIR levels.

Main Methods:

  • A study involving 97 preterm infants (<37 weeks gestation, <2500g birth weight) was conducted.
  • Infants were categorized into three groups based on GIR: 5-<7 g/kg/day, 7-13 g/kg/day, and >13-15 g/kg/day.
  • Logistic regression analyses were used to assess the association between GIR and neonatal morbidities (RDS, necrotizing enterocolitis, sepsis, retinopathy of prematurity, pulmonary hypertension, hypoglycemia, hyperglycemia) and mortality.

Main Results:

  • Lower GIR (5-<7 g/kg/day) was independently associated with a significantly increased risk of hypoglycemia (AOR=4.000) and a reduced risk of sepsis (AOR=0.096).
  • No significant increase in mortality risk was observed across all GIR groups.
  • Respiratory distress syndrome (RDS) was identified as an independent risk factor for mortality (AOR=5.404).

Conclusions:

  • Glucose infusion rates below 7 g/kg/day in parenteral nutrition for preterm infants are linked to increased hypoglycemia risk.
  • Conversely, lower GIR (<7 g/kg/day) demonstrated a protective effect against sepsis in this population.
  • Respiratory distress syndrome remains a critical factor influencing mortality in preterm infants.
Abstract

Keywords:
Glucose infusion rateMorbidityMortalityParenteral nutritionPreterm infant

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