Néonatologie et Réanimation Néonatale, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, France.
Acta Paediatr. 2013 Mar;102(3):242-8. doi: 10.1111/apa.12092. Epub 2012 Dec 27.
To evaluate the impact of an improved nutritional policy for extremely low birthweight (ELBW) infants on nutritional deficits and postnatal growth.
We compared two groups of 37 ELBW infants, born before and after the introduction of an improved nutritional policy in April 2006. Group A (born 2005 to early 2006) and group B (born 2009) stayed in a French neonatal intensive care unit (NICU) for at least 7 weeks. Optimal energy and protein intakes were 120 and 3.5 g/kg/day, respectively, and used to calculate cumulative deficits. Delta z-scores for weight, length and head circumference were calculated between birth and 36 weeks of postmenstrual age (PMA). The improved nutritional policy focused on earlier and higher parenteral intake of lipids and proteins, earlier and higher human milk fortification and earlier transition to preterm formula.
The two groups did not differ in gestational age and birthweight. However, protein and energy deficits were significantly reduced in group B. Between birth and 36 weeks of PMA, delta z-scores were significantly reduced for length (p = 0.012) but not for weight (p = 0.09) or head circumference (p = 0.83).
Higher parenteral intake and close attention to enteral feeding reduced nutritional deficits and linear growth restriction in infants admitted to a French NICU.
评估改良极低出生体重儿（ELBW）营养政策对营养不足和生后生长的影响。
我们比较了两组 37 例 ELBW 婴儿，分别在 2006 年 4 月改良营养政策引入前（A 组，2005 年至 2006 年初出生）和后（B 组，2009 年出生）入组。两组均在法国新生儿重症监护病房（NICU）住院至少 7 周。目标能量和蛋白质摄入量分别为 120 和 3.5 g/kg/d，并用于计算累积缺乏量。体重、身长和头围的 delta z 评分在出生至校正胎龄 36 周（PMA）之间计算。改良营养政策侧重于更早和更高的肠外脂质和蛋白质摄入、更早和更高的人乳强化以及更早过渡到早产儿配方。
两组在胎龄和出生体重方面无差异。然而，B 组的蛋白质和能量缺乏明显减少。在出生至 PMA36 周期间，身长的 delta z 评分显著降低（p=0.012），而体重（p=0.09）或头围（p=0.83）的 delta z 评分无显著差异。
更高的肠外摄入和密切关注肠内喂养减少了法国 NICU 中婴儿的营养不足和线性生长受限。
