Enteral nutrition practices and associated outcomes in preterm infants with a gestational age less than 34 weeks: a...

This study aims to assess the current status of enteral nutrition (EN) in preterm infants with a gestational age (GA) less than 34 weeks at a single neonatal intensive care unit (NICU) and to identify factors associated with delayed achievement of total enteral nutrition (TEN).

A retrospective analysis was conducted on 137 preterm infants with GA less than 34 weeks admitted to the NICU of Jingzhou Hospital Affiliated to Yangtze University between December 2019 and June 2024. Infants were categorized into Group A (GA < 32 weeks) and Group B (GA ≥ 32 weeks). Each group was further divided into subgroups based on whether TEN was achieved within 21 days (Group A1) or not (Group A2), and within 14 days (Group B1) or not (Group B2), respectively. Differences in EN practices and clinical complications were compared using t-tests, rank sum tests, chi-squared tests, or Fisher's exact tests.

The initiation of enteral feeding within 48 h and 24 h after birth occurred in 97.08% and 46.72% of cases, respectively. The mean time to achieve TEN was 42.50±22.06 days for infants with GA 26⁺⁰-27⁺⁶ weeks, 28.69±9.78 days for GA 28⁺⁰-31⁺⁶ weeks, and 17.27±0.70 days for GA 32⁺⁰-33⁺⁶ weeks. The median time to achieve TEN was 21 days in Group A and 14 days in Group B. Initial feeding volumes in Groups A1 (11.35 mL/kg·d) and B1 (15.05 mL/kg·d) were significantly higher than those in Groups A2 (6.09 mL/kg·d) and B2 (12.77 mL/kg·d), respectively. A more rapid advancement of feeding volume during the first one to 2 weeks after birth was also observed in Groups A1 and B1 (p < 0.05 or 0.01). The incidence of bronchopulmonary dysplasia (BPD) in Group A1 and feeding intolerance in Group B1 were lower compared to their respective control groups (p < 0.05).

Preterm infants with GA less than 34 weeks showed a delay in the achievement of TEN. Higher initial feeding volumes and a faster rate of feeding advancement within the first 2 weeks after birth were associated with earlier achievement of TEN and a lower incidence of BPD.