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Association of Standardized Parenteral Nutrition with Early Neonatal Growth of Moderately Preterm Infants: A
Laurence Fayol1,2, Jilnar Yaacoub1, Marine Baillat1
1Department of Neonatology, Hôpital La Conception, Hôpitaux Universitaires de Marseille, 13005 Marseille, France.
Insights
Standardized parenteral nutrition using three-in-one double-chamber solutions (3-in-1 STD-PN) in moderately preterm infants limited early weight loss. This approach also improved parenteral energy and protein delivery during the first week of life.
Area of Science:
- Neonatalogy
- Pediatric Nutrition
- Intensive Care
Background:
- Early nutrient intake in preterm infants often relies on parenteral nutrition (PN).
- Optimizing PN is crucial for neonatal growth and development.
- Standardized PN solutions may offer benefits for vulnerable infants.
Purpose of the Study:
- To evaluate the impact of standardized three-in-one double-chamber parenteral nutrition (3-in-1 STD-PN) on early neonatal growth.
- To assess the influence of 3-in-1 STD-PN on weight changes in moderately preterm (MP) infants.
- To compare nutrient delivery between 3-in-1 STD-PN and other PN methods.
Main Methods:
- Population-based observational cohort study of MP infants (32-34 weeks gestation) requiring PN from birth.
- Inclusion of 315 MP infants, with 178 receiving 3-in-1 STD-PN.
- Multivariate regression analysis to determine factors associated with relative body-weight difference (RBWD) between days 1 and 7.
Main Results:
- Infants on 3-in-1 STD-PN experienced 36% less body weight loss in the first week (median RBWD -2.5% vs. -3.9%).
- Higher parenteral energy (85% more) and protein (27% more) intake were observed on day-of-life 3 with 3-in-1 STD-PN.
- Adjusted analysis showed significantly lower RBWD in the 3-in-1 STD-PN group (beta = 2.08, p = 0.02).
Conclusions:
- Standardized three-in-one double-chamber parenteral nutrition effectively limits early weight loss in moderately preterm infants.
- 3-in-1 STD-PN enhances parenteral energy and protein delivery in the neonatal period.
- This standardized approach supports better early growth outcomes for MP infants requiring PN.
Abstract:
In preterm infants, early nutrient intake during the first week of life often depends on parenteral nutrition. This study aimed to evaluate the influence of standardized parenteral nutrition using three-in-one double-chamber solutions (3-in-1 STD-PN) on early neonatal growth in a cohort of moderately preterm (MP) infants. This population-based, observational cohort study included preterm infants admitted to neonatal centers in the southeast regional perinatal network in France. During the study period, 315 MP infants with gestational ages between 320/7 and 346/7 weeks who required parenteral nutrition from birth until day-of-life 3 (DoL3) were included; 178 received 3-in-1 STD-PN solution (56.5%). Multivariate regression was used to assess the factors associated with the relative body-weight difference between days 1 and 7 (RBWD DoL1-7). Infants receiving 3-in-1 STD-PN lost 36% less body weight during the first week of life, with median RBWD DoL1-7 of -2.5% vs. -3.9% in infants receiving other PN solutions (p < 0.05). They also received higher parenteral energy and protein intakes during the overall first week, with 85% (p < 0.0001) and 27% (p < 0.0001) more energy and protein on DoL 3. After adjusting for confounding factors, RBWD DoL1-7 was significantly lower in the 3-in-1 STD-NP group than in their counterparts, with beta (standard deviation) = 2.08 (0.91), p = 0.02. The use of 3-in-1 STD-PN provided better energy and protein intake and limited early weight loss in MP infants.
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