Department of Pediatrics, Medisch Spectrum Twente, Enschede, the Netherlands.
Amsterdam UMC, Academic Medical Center, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, University of Amsterdam, the Netherlands.
Nutr Clin Pract. 2020 Aug;35(4):729-737. doi: 10.1002/ncp.10464. Epub 2020 Mar 3.
The purpose of the study was to evaluate differences between prescribed and recommended protein intake in moderate-preterm (MP) and late-preterm (LP) infants and examine the contribution of the first week's prescribed protein intake to growth until term age.
Data on intake and anthropometrics were collected retrospectively in 235 preterm infants admitted to our general hospital's neonatal ward: 60 MP (32 -33 weeks' gestational age) and 175 LP (34 -36 weeks' gestational age). Differences between prescribed and recommended protein intake during the first postnatal week and z-score change for weight and head circumference (HC) between birth and term age were calculated. Multiple regression was used to evaluate the independent contribution of first week's prescribed protein intake to growth until term age.
At day 7, 58% of MP and 19% of LP infants reached recommended protein intake. At term age, mean z-score change was -0.4 for weight and +0.1 for HC. Mean protein intake (g/kg/d) was associated with z-score change of +0.34 (95% CI, 0.14-0.53; P < .001) for weight and +0.25 (95% CI, 0-0.5; P = .03) for HC. Reaching recommended protein intake at day 7 was only independently associated with weight z-score change (+0.22 [95% CI, 0.04-0.41; P = .002]).
First week's prescribed protein intake does not meet recommended intake. Higher protein intakes in the first postnatal week result in increased weight gain and head growth until term age. Desirability and feasibility of increasing the protein intake need careful consideration and further discussion.
本研究旨在评估中早产儿(MP)和晚期早产儿(LP)的规定蛋白质摄入量与推荐摄入量之间的差异,并研究第一周规定蛋白质摄入量对至足月龄时生长的贡献。
回顾性收集了我院新生儿病房收治的 235 例早产儿的数据,包括摄入量和人体测量学数据:60 例 MP(32-33 周胎龄)和 175 例 LP(34-36 周胎龄)。计算了第一周规定蛋白质摄入量与推荐摄入量之间的差异以及出生至足月龄时体重和头围(HC)的 z 评分变化。采用多元回归评估第一周规定蛋白质摄入量对直至足月龄时生长的独立贡献。
第 7 天,58%的 MP 婴儿和 19%的 LP 婴儿达到了推荐的蛋白质摄入量。在足月龄时,体重的平均 z 评分变化为-0.4,HC 的平均 z 评分变化为+0.1。平均蛋白质摄入量(g/kg/d)与体重的 z 评分变化呈正相关,+0.34(95%CI,0.14-0.53;P<.001),与 HC 的 z 评分变化呈正相关,+0.25(95%CI,0-0.5;P=0.03)。第 7 天达到推荐蛋白质摄入量仅与体重 z 评分变化独立相关(+0.22[95%CI,0.04-0.41;P=0.002])。
第一周的规定蛋白质摄入量未达到推荐摄入量。第一周更高的蛋白质摄入量可导致体重增加和头围增长,直至足月龄。增加蛋白质摄入量的适宜性和可行性需要仔细考虑和进一步讨论。