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Growth and Neurodevelopmental Outcomes of Preterm Infants Born < 26 Weeks Gestation before and after Implementation

Giulia Res1,2, Rosine F Bishara1, Paige Terrien Church3,4

  • 1Department of Newborn and Developmental Paediatrics, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada.

Children (Basel, Switzerland)
|April 27, 2024
PubMed

Insights

A nutrition-care bundle did not significantly improve growth or neurodevelopment in micro-preterm infants. High-quality care may explain the lack of difference in outcomes.

Area of Science:

  • Neonatal Intensive Care Unit (NICU) research
  • Pediatric nutrition interventions
  • Neurodevelopmental pediatrics

Background:

  • Micro-preterm infants (< 26 weeks gestation) face significant growth and neurodevelopmental challenges.
  • Optimizing nutrition is critical for improving outcomes in this vulnerable population.
  • A structured nutrition-care bundle was implemented to enhance early nutritional support.

Purpose of the Study:

  • To evaluate the impact of a nutrition-care bundle on growth and neurodevelopmental outcomes.
  • To compare outcomes in micro-preterm infants before and after the bundle's implementation.
  • To assess outcomes up to two years corrected age.

Main Methods:

  • A before-and-after study design compared two cohorts of infants born < 26 weeks gestation.
  • The intervention involved a nutrition-care bundle: early parenteral nutrition, enteral feeds within 6 hours, and early human milk fortifier addition.
  • Growth and neurodevelopmental outcomes were assessed by two years corrected age.

Main Results:

  • The group receiving the nutrition-care bundle (ANB) had infants with lower birthweight and gestational age compared to the before-nutrition-bundle (BNB) group.
  • Earlier initiation of enteral feeds and fortifiers was observed in the ANB group.
  • Growth velocity and weight z-score changes were similar between groups; systemic steroid use, not the nutrition bundle, correlated with lower neurodevelopmental scores.

Conclusions:

  • The implemented nutrition-care bundle did not demonstrate a consistent association with improved weight gain or neurodevelopmental outcomes in micro-preterm infants.
  • The lack of significant improvement may be attributed to the consistently high standard of nutritional care provided by the clinical team.
  • Further research may be needed to refine nutritional strategies for this population.
Abstract

Keywords:
growthmicro-pretermneurodevelopmental outcomesnutrition bundle

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