Department of Neonatology, University of Liege, CHU de Liège, CHR de la Citadelle, Belgium.
Acta Paediatr. 2012 Feb;101(2):e64-70. doi: 10.1111/j.1651-2227.2011.02443.x. Epub 2011 Sep 27.
To evaluate the influence of gestational age (GA) on cumulative nutritional deficit and postnatal growth in extremely preterm (EPT) infants after optimizing nutritional protocol as recently recommended.
A prospective, nonrandomized, observational study in extremely preterm (EPT, <28 weeks) and very preterm (VPT, 28-30 weeks) infants.
Eighty-four infants were included (BW: 978 ± 156 g, GA: 27.8 ± 1.3 weeks). Cumulative nutritional deficit increased during first week of life to -290 ± 84 and -285 ± 117 kcal/kg and -4.2 ± 3.1 and -4.8 ± 3.9 g/kg of protein in EPT and VPT groups, respectively. After 6 weeks, only cumulative energy deficit in EPT group remained significant (p < 0.05) even when 96% of theoretical energy intakes were provided. Weight z score decreased during first 3 days in average with initial weight loss, and then, the z score increased during the first 6 weeks of life in the majority (75%) of infants. Cumulative protein deficit during the first week of life was the major determinant of the postnatal growth during the first 6 weeks of life.
Cumulative nutritional deficit may be drastically reduced in both EPT and VPT infants after optimizing nutritional policy during the first weeks of life, and the postnatal growth restriction could even be prevented.
评估在优化最近推荐的营养方案后，胎龄（GA）对极早产儿（EPT）婴儿累积营养不足和生后生长的影响。
一项前瞻性、非随机、观察性研究，纳入极早产儿（EPT，<28 周）和非常早产儿（VPT，28-30 周）婴儿。
84 例婴儿纳入研究（BW：978±156 g，GA：27.8±1.3 周）。在生命的第一周，累积营养不足分别增加到-EPT 组和-VPT 组的-290±84 和-285±117 kcal/kg，-4.2±3.1 和-4.8±3.9 g/kg 蛋白质。6 周后，即使提供了 96%的理论能量摄入量，EPT 组的累积能量不足仍有显著差异（p<0.05）。体重 z 评分在最初的体重下降期间在平均 3 天内下降，然后在大多数（75%）婴儿的生命的前 6 周内增加。生后第一周的累积蛋白质不足是生后前 6 周内生长的主要决定因素。
在生命的最初几周优化营养方案后，EPT 和 VPT 婴儿的累积营养不足可能会大大减少，甚至可以预防生后生长受限。
