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极早产儿至2岁矫正年龄的早期营养与生长

Early Nutrition and Growth until the Corrected Age of 2 Years in Extremely Preterm Infants.

作者信息

Hiltunen Henni, Löyttyniemi Eliisa, Isolauri Erika, Rautava Samuli

机构信息

Department of Pediatrics, University of Turku, Turku, Finland.

出版信息

Neonatology. 2018;113(2):100-107. doi: 10.1159/000480633. Epub 2017 Nov 10.

Abstract

BACKGROUND

Extremely preterm birth is associated with a high risk of extrauterine growth retardation, which has been linked with adverse developmental outcomes.

OBJECTIVE

We investigated whether nutritional management during the first 7 days of life affects growth patterns until the corrected age of 2 years in extremely preterm infants.

STUDY DESIGN

A retrospective study of 78 extremely preterm (<28 weeks' gestation) neonates was conducted. Data regarding parenteral and enteral intake of energy, protein, lipids, and carbohydrates during the first 7 days of life were collected from patient records. The outcome measures included weight, height, and head circumference with Z scores at term-equivalent age and the corrected ages of 1 and 2 years. Analyses were performed with hierarchical-linear mixed models.

RESULTS

Nutritional intake during the first week of life did not reach the current recommendations. The total energy intake during the first 7 days of life was statistically significantly associated with weight, length, and head circumference until the corrected age of 2 years after adjusting for potential confounding factors. Individual macronutrient intake displayed no association with growth patterns.

CONCLUSIONS

Energy intake during the first 7 days of life is associated with growth until the corrected age of 2 years. These results provide support for the aggressive early nutritional management of extremely preterm infants.

摘要

背景

极早产儿宫外生长发育迟缓风险高,这与不良发育结局相关。

目的

我们调查了极早产儿出生后7天内的营养管理是否会影响其至2岁矫正年龄时的生长模式。

研究设计

对78例极早产儿(孕周<28周)进行了一项回顾性研究。从患者记录中收集出生后7天内肠外和肠内能量、蛋白质、脂质及碳水化合物摄入量的数据。结局指标包括足月等效年龄以及1岁和2岁矫正年龄时的体重、身高和头围的Z评分。采用分层线性混合模型进行分析。

结果

出生后第一周的营养摄入量未达到当前建议水平。在调整潜在混杂因素后,出生后7天内的总能量摄入量与至2岁矫正年龄时的体重、身长和头围在统计学上显著相关。个体宏量营养素摄入量与生长模式无关联。

结论

出生后7天内的能量摄入与至2岁矫正年龄时的生长相关。这些结果为极早产儿积极的早期营养管理提供了支持。

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