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Parenteral nutrition using corrected weight to the 10th percentile improves weight gain in preterm neonates: A

Panos Papandreou1, Alexandra Foscolou2, Eirini Bampoukli2

  • 1Department of Nutrition, IASO Hospital, 37-39 Kifissias Ave., 15123 Athens, Greece.

Clinical Nutrition ESPEN
|February 7, 2026
PubMed

Insights

Parenteral nutrition (PN) guided by a clinical decision support system (CDSS) using 10th percentile corrected weight improved weight gain in preterm small for gestational age (SGA) neonates. This method offers a favorable combination for enhanced neonatal growth.

Area of Science:

  • Neonatalogy
  • Pediatric Nutrition
  • Clinical Decision Support Systems

Background:

  • Parenteral nutrition (PN) is vital for nutritional support in preterm and small for gestational age (SGA) neonates.
  • Optimizing PN in this vulnerable population remains a clinical challenge.
  • Accurate weight estimation is critical for appropriate PN dosing.

Purpose of the Study:

  • To evaluate the efficacy of PN administration in preterm SGA neonates using corrected weight at the 10th percentile.
  • To assess the impact of a clinical decision support system (CDSS) on neonatal growth outcomes.
  • To compare weight gain between neonates receiving PN based on actual birth weight versus 10th percentile corrected weight.

Main Methods:

  • A randomized controlled study involving 100 preterm SGA neonates.
  • Participants were assigned to a Control group (PN based on actual birth weight) or an Intervention group (PN based on 10th percentile corrected weight), both using a CDSS.
  • Growth indicators (weight, length, head circumference) were measured at baseline and endpoint.

Main Results:

  • No significant baseline differences in gestational age, sex, or birth parameters between groups.
  • The intervention group showed a significantly greater median weight gain (+0.16 kg) compared to the control group (+0.09 kg) (p=0.034).
  • Relative body weight change was significantly higher in the intervention group (+13.6%) versus the control group (+6.4%) (p=0.047).

Conclusions:

  • Estimating nutrient needs based on the 10th percentile of weight, aided by a CDSS, promotes faster weight gain in SGA neonates.
  • This approach represents a favorable strategy for improving growth outcomes in this population.
  • The study highlights the potential of CDSS-guided, percentile-based weight adjustments in neonatal PN.
Abstract

Keywords:
Body weightClinical decision support systemMacronutrientsNeonatesParenteral nutritionSmall for gestational age

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