Department of Neonatology, University of Liege, CHU de Liège, CHR de la Citadelle, Liège, Belgium.
J Pediatr Gastroenterol Nutr. 2011 Nov;53(5):536-42. doi: 10.1097/MPG.0b013e31822a009d.
The aim of this study was to evaluate postnatal growth up to discharge in very low birth weight infants after optimizing nutritional support based on recent nutritional recommendations.
A prospective, nonrandomized, consecutive, and observational study in infants weighing <1250 g.
One hundred two infants were included during a 2-year period (birth weight 1005 ± 157 g, gestational age 28.5 ± 1.9 weeks). First-day nutritional intake was 38 ± 6 kcal/kg/day with 2.4 ± 0.3 g/kg/day of protein. Mean intake during the first week of life was 80 ± 14 kcal/kg/day with 3.2 ± 0.5 g/kg/day of protein. On average from birth to discharge, 122 ± 10 kcal/kg/day and 3.7 ± 0.2 g/kg/day of protein were administered. Postnatal weight loss was limited to the first 3 days of life, and birth weight was regained after 7 days in average. Catch-up occurred after the second week in all groups of very low birth weight infants. Small-for-gestational age infants demonstrated an earlier and higher weight gain, allowing a rapid catch-up growth. The same proportion of infants was small-for-gestational age at birth and at discharge (20%, P = 0.74).
This study confirmed that the first week of life is a critical period to promote growth and that early nutrition from the first day of life is essential. Postnatal weight loss may be limited and subsequent growth may be optimized with a dramatic reduction of postnatal growth restriction.
本研究旨在根据最新营养建议优化营养支持后，评估极低出生体重儿出院时的产后生长情况。
这是一项前瞻性、非随机、连续、观察性研究，纳入体重<1250g 的婴儿。
在 2 年期间（出生体重 1005±157g，胎龄 28.5±1.9 周）共纳入 102 例婴儿。第 1 天的营养摄入量为 38±6kcal/kg/天，蛋白质摄入量为 2.4±0.3g/kg/天。生命的第 1 周平均摄入量为 80±14kcal/kg/天，蛋白质摄入量为 3.2±0.5g/kg/天。从出生到出院，平均每天给予 122±10kcal/kg/天和 3.7±0.2g/kg/天的蛋白质。出生后体重减轻仅限于生命的前 3 天，平均 7 天后恢复出生体重。所有极低出生体重儿组在第 2 周后均出现追赶生长。小于胎龄儿表现出更早和更高的体重增长，允许快速追赶生长。出生时和出院时的小于胎龄儿比例相同（20%，P=0.74）。
本研究证实生命的第 1 周是促进生长的关键时期，生命第 1 天的早期营养至关重要。出生后体重减轻可能有限，随后的生长可以通过显著减少出生后生长受限来优化。
