McLeod Gemma, Simmer Karen, Sherriff Jill, Nathan Elizabeth, Geddes Donna, Hartmann Peter
Centre for Neonatal Research and Education, School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia.
School of Public Health, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia.
J Paediatr Child Health. 2015 Sep;51(9):862-9. doi: 10.1111/jpc.12893. Epub 2015 Apr 14.
Preterm nutrition guidelines target nutrient accretion and growth at intrauterine rates, yet at term equivalent age, the phenotype of the preterm infant differs from that of term infants. Monitoring early changes in preterm body composition (BC) in response to macronutrient intakes may facilitate our understanding of how best to meet preterm nutrition and growth targets.
Macronutrient intakes based on milk analysis were calculated from birth for infants born <33 weeks gestation. BC was measured in the PEA POD when infants were thermodynamically stable, free of intravenous lines and independent of respiratory support. Subsequent BC measurements were taken at least fortnightly until term age. Regression analysis was used to assess macronutrient influences on changes in BC.
Median (range) gestation and birthweight of preterm infants (n = 27) were 29 (25-32) weeks and 1395 (560-2148) g, respectively. The youngest corrected gestational and postnatal ages that infants qualified for a PEA POD measurement were 31.86 and 1.43 weeks, respectively. Fat and total energy intakes were positively associated with increasing fat mass. Protein (with carbohydrate) intake was positively associated with increasing fat-free mass.
Preterm infants can be measured in the PEA POD as early as 31 weeks corrected gestational age and the method appears sufficiently sensitive to detect influences of macronutrient intake on changes in BC.
早产营养指南以子宫内生长速率的营养积累和生长为目标，但在足月等效年龄时，早产儿的表型与足月儿不同。监测早产儿身体成分（BC）对常量营养素摄入的早期变化，可能有助于我们了解如何以最佳方式实现早产营养和生长目标。
对于孕周小于33周出生的婴儿，从出生起根据乳汁分析计算常量营养素摄入量。当婴儿体温稳定、无静脉输液管且无需呼吸支持时，使用PEA POD测量BC。随后至少每两周进行一次BC测量，直至足月年龄。采用回归分析评估常量营养素对BC变化的影响。
早产儿（n = 27）的孕周中位数（范围）为29（25 - 32）周，出生体重中位数（范围）为1395（560 - 2148）g。婴儿符合PEA POD测量条件的最小校正孕周和出生后年龄分别为31.86周和1.43周。脂肪和总能量摄入与脂肪量增加呈正相关。蛋白质（与碳水化合物一起）摄入与去脂体重增加呈正相关。
早产儿在校正孕周31周时即可使用PEA POD进行测量，该方法似乎足够灵敏，能够检测常量营养素摄入对BC变化的影响。
