Klingenberg Claus, Muraas Fredrik Kragh, Isaksen Catherine Elde, Nilsen Tina, Torgersen Marte, Melum-Hansen Cecilie
a Division of Child and Adolescent Health, Department of Paediatrics , University Hospital of North Norway , Tromsø , Norway.
b Paediatric Research Group, Faculty of Health Sciences , University of Tromsø , Tromsø , Norway.
J Matern Fetal Neonatal Med. 2019 May;32(10):1664-1672. doi: 10.1080/14767058.2017.1414796. Epub 2017 Dec 17.
The aim of this study is to evaluate a feeding regimen routinely providing >180 ml/kg/d fortified human milk to very preterm infants and impact on in-hospital growth, osteopenia, and neurodevelopment.
Retrospective population-based descriptive study of infants <30-week gestation admitted within 24 h of birth and discharged during the 6-year period 2005-2010. Growth and neurodevelopment was assessed until 2 years corrected age, and cerebral palsy up to 4 years corrected age Results: Ninety-nine infants below 30-week gestation were admitted within 24 h of birth during the 6-year period, of which 84 (85%) survived to discharge. Two infants had surgical necrotizing enterocolitis, both survived to 2 years follow up. Seventy-eight infants (mean 27 weeks) had complete growth data until discharge. Full enteral feeds were tolerated after mean 10 d. Average milk volumes were 193 ml/kg/d from 15 to 42 d of life. Rates of weight below 10th centile were 10% at birth and 14% at discharge. Head circumference Z-scores were stable from birth to discharge. Blood values did not indicate osteopenia. Increasing head circumference Z-scores were associated with improved language development.
This high enteral feeding volume regimen was associated with low rates of in-hospital growth restriction and good head growth. High enteral volume intake seems safe and may improve nutritional status of very preterm infants.
本研究旨在评估一种常规为极早产儿提供>180毫升/千克/天强化母乳的喂养方案及其对住院期间生长、骨质减少和神经发育的影响。
对2005年至2010年6年间出生后24小时内入院且孕周<30周、出院的婴儿进行基于人群的回顾性描述性研究。评估生长和神经发育直至矫正年龄2岁，评估脑瘫直至矫正年龄4岁。结果：6年间有99例孕周<30周的婴儿在出生后24小时内入院，其中84例（85%）存活至出院。2例婴儿发生外科坏死性小肠结肠炎，均存活至2年随访。78例婴儿（平均27周）有直至出院的完整生长数据。平均10天后可耐受完全肠内喂养。出生后15至42天的平均奶量为193毫升/千克/天。出生时体重低于第10百分位数的比例为10%，出院时为14%。头围Z评分从出生到出院保持稳定。血液指标未显示骨质减少。头围Z评分增加与语言发育改善相关。
这种高肠内喂养量方案与住院期间生长受限发生率低和头围良好生长相关。高肠内摄入量似乎安全，可能改善极早产儿的营养状况。
