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Test Weight Validation In Preterm Infants
Meredith Kinoshita1,2, Martin J White1,2, Anne Doolan1,3
1The Coombe Hospital, Dublin, Ireland.
Insights
Accurate feed intake measurement is crucial for preterm infants. Standardized bedside test weights are reproducible and reliable for assessing intake during oral feeding transitions.
Area of Science:
- Neonatal Medicine
- Pediatric Nutrition
- Clinical Measurement
Background:
- Accurate assessment of feed intake is vital for preterm infants at risk of growth failure.
- Existing clinical observation tools lack validation in this population.
- Test weight measurement may be inaccurate for small feed volumes in preterm infants.
Purpose of the Study:
- To assess the agreement between standardized test weights and known feed weights in preterm infants.
- To evaluate the reproducibility of test weight measurements during oral feeding transitions.
- To determine the minimal detectable change for feed intake assessment in this population.
Main Methods:
- A standardized protocol for repeated pre- and post-feed weights was used in preterm infants (<35 weeks gestational age).
- Reproducibility was assessed via two repeated measurements per participant.
- Agreement between test weights and known feed weights was analyzed, and minimal detectable change was calculated.
Main Results:
- Thirty-eight preterm infants were studied, with test weights performed at corrected gestational age 35+3 weeks.
- High reproducibility was found for paired pre-feed weights (ICC=0.99) and post-feed weights (ICC=0.99).
- The mean absolute difference between test weight and feed weight was 1.7 g, with a minimal detectable change of 0.96 g.
Conclusions:
- A standardized bedside protocol for repeated pre- and post-feed weights demonstrates high reproducibility in preterm infants.
- Test weight measurements are appropriate for use in preterm populations during the establishment of oral feeds.
- This method provides accurate and reliable assessment of feed intake, crucial for monitoring growth.
Abstract:
Accuracy in the assessment of feed intake is important for preterm infants at risk of growth failure. Clinical observation tools are unvalidated in this population, and test weight measurement may be inaccurate in preterm infants taking small feed volumes. Test weights were performed to assess agreement between weights using a standardized protocol and a feed of known weight in preterm infants (born at <35 weeks gestational age [GA]) during their transition to oral feeding. Reproducibility was assessed using two repeated measurements in each participant. Agreement between test weights and known feed weights was assessed, and minimal detectable change was calculated. Thirty-eight preterm infants (GA 30 + 5 (28-33 + 1), birth weight 1574 g (+/- 671 g)) were recruited and had test weights performed at CGA 35 + 3 (± 10 days). Each infant was weighed twice before and twice after each measured feed, and a high degree of reproducibility was found for both the paired pre-feed weights, ICC = 0.99 [0.99-0.99] and the paired post-feed weights, ICC = 0.99 [0.99-0.99]. The mean absolute difference between test weight and feed weight was 1.7 g (±2.2). We calculated the minimum detectable change as 0.96 g, representing the magnitude of change below which there is more than 95% chance that no real change occurred. During the establishment of oral feeds, a standardized protocol at the bedside for repeated pre- and post-feed weights demonstrated a high degree of reproducibility. Based on our data, test weight measurements are appropriate for use in this preterm population during the establishment of oral feeds.
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