Sex-Related Nutritional Outcomes Among Preterm Very Low Birth-Weight Infants
Leslie A Parker1, Michael Weaver, Diomel de la Cruz
1Author Affiliations: Department of Biobehavioral Nursing Science, College of Nursing (Drs Parker and Weaver); and Department of Pediatrics, Division of Neonatology, College of Medicine, University of Florida, Gainesville Florida (Drs de la Cruz and Neu).
Insights
Male preterm infants experienced longer nutritional support durations and higher rates of complications like sepsis. These findings highlight the need for sex-specific nutritional strategies in neonatal intensive care units for very low birth-weight infants.
Area of Science:
- Neonatal nutrition
- Pediatric growth and development
- Sex-based biological differences
Background:
- Optimal nutrition is critical for growth and reducing neurodevelopmental impairment in preterm very low birth-weight (VLBW) infants.
- Existing knowledge on sex-specific nutritional outcomes in VLBW infants is limited.
- Understanding these differences is crucial for tailored infant care.
Purpose of the Study:
- To investigate the impact of infant sex on the time to achieve full enteral feedings.
- To analyze other sex-specific nutritional outcomes in VLBW infants.
- To inform precision-based nutritional support in neonatal intensive care.
Main Methods:
- Longitudinal cohort study with secondary analysis of existing data.
- Inclusion criteria: 313 infants born ≤32 weeks gestation and weighing ≤1500 g.
- Nutritional outcomes data extracted from electronic medical records.
Main Results:
- Male infants trended towards longer durations for full enteral feeds, parenteral nutrition, and central line use, though not statistically significant.
- Males exhibited significantly higher direct bilirubin levels, emesis, and late-onset sepsis.
- While males had higher initial birth weight and weight gain slope, 6-week weight and growth velocity were similar, tending higher in females.
Conclusions:
- Nurses play a vital role in optimizing nutrition for preterm infants.
- Evidence suggests sex-specific differences in nutritional outcomes for VLBW infants.
- Precision-based nutritional support considering sex is recommended for neonatal care.
Background:
Sex-specific differences exist in morbidity and growth yet little is known about other nutritional outcomes in preterm very low birth-weight (VLBW) infants. This is important because providing optimal nutrition is essential to promote growth and reduce neurodevelopmental impairment.
Purpose:
To determine the effect of sex on days to full enteral feedings and other nutritional outcomes.
Methods:
This was a longitudinal 2-group cohort study using secondary analysis of existing data of 313 infants born ≤32 weeks gestation and weighing ≤1500 g. Information regarding nutritional outcomes was obtained from the infant's electronic medical records.
Results:
While not statistically significant, male infants reached full feeds nearly 3 days later (18.1 vs 15.2; P = .89), required parenteral nutrition for nearly an additional 4 days (18.3 vs 14.1; P = .37), and had a central line for 3 days longer (19.6 vs 15.7; P = .65) than female infants. Males had higher direct bilirubin levels ( P = .02), more emesis ( P = .003), and more late-onset sepsis ( P = .03). Birth weight for males was higher at birth but not at 6 weeks and while the slope of weight increase over the 6 weeks was higher in males ( P = .04), growth velocity was similar between sexes yet tended to be higher in females.
Implications For Practice And Research:
Nurses are essential in ensuring preterm infants in the neonatal intensive care unit receive optimal nutrition. This study supports nurses should consider sex-specific differences in nutritional outcomes among VLBW infants in precision based nutritional support.
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