Department of Pediatrics, Division of Neonatology, Erasmus MC - Sophia Children's Hospital, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands; Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands.
Department of Pediatrics, Intensive Care Unit, Erasmus MC - Sophia Children's Hospital, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands.
Clin Nutr. 2018 Oct;37(5):1526-1533. doi: 10.1016/j.clnu.2017.08.023. Epub 2017 Aug 31.
BACKGROUND & AIMS: Aggressive parenteral nutritional practices were implemented in clinical practice over a decade ago to prevent early growth retardation in preterm infants. We aimed to study adherence to current nutritional recommendations in a population of very preterm infants, and to evaluate growth in early life.
Preterm infants (gestational age <30 weeks and birth weight <1500 g) were included in a prospective observational cohort study. Data on parenteral and enteral intake were collected on days 1-7, 14, 21 and 28 (d28) of life. Growth data were collected at birth, at moment of maximal weight loss (dip), and either at discharge from the neonatal intensive care unit or at d28, whichever came first. Nutritional intakes were compared to recommendations of current guidelines. The target growth rate was 15-20 g/kg/d.
Fifty-nine infants (63% male) were included. Median gestational age was 27 3/7 (interquartile range 25 6/7;28 4/7), and birth weight was 920 g (720;1200). Median macronutrient intakes were within or above the targets on all study days, but energy targets were not met before day 5. Median growth rates were 9.5 and 18.1 g/kg/d, when calculated from respectively birth and dip to discharge/d28. Eight (14%) versus 46 (78%) infants met the growth targets, when evaluated from respectively birth and dip to discharge/d28.
In this cohort, only energy intake up to day 5 was lower than recommended. Growth targets were achieved in the majority of the infants, but only when evaluated from dip onward, not from birth.
十多年前，临床上实施了积极的肠外营养实践，以防止早产儿早期生长迟缓。我们旨在研究非常早产儿人群中当前营养建议的依从性，并评估其早期的生长情况。
将（胎龄<30 周且出生体重<1500g）早产儿纳入一项前瞻性观察队列研究。在生命的第 1-7、14、21 和 28 天（d28）收集肠外和肠内摄入的数据。在出生时、体重最大损失（低谷）时以及从新生儿重症监护病房出院或 d28 时（以先到者为准）收集生长数据。将营养摄入量与当前指南的建议进行比较。目标生长速度为 15-20g/kg/d。
共纳入 59 名婴儿（63%为男性）。中位胎龄为 27 3/7（四分位间距 25 6/7；28 4/7），出生体重为 920g（720g；1200g）。所有研究日的宏量营养素摄入量均在目标范围内或以上，但在第 5 天之前未达到能量目标。从出生到出院/d28 计算，中位生长速度分别为 9.5 和 18.1g/kg/d。从出生到出院/d28 评估时，8 名（14%）婴儿与 46 名（78%）婴儿达到了生长目标。
在本队列中，只有第 5 天之前的能量摄入量低于建议量。大多数婴儿达到了生长目标，但仅在从低谷开始评估时，而不是从出生开始评估时。
