Neonatology, Instituto Nacional da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, FIOCRUZ, Av. Rui Barbosa, 760, Flamengo, RJ, CEP 22250-020, Rio de Janeiro, Brazil.
Post-graduation on Applied Clinical Research, Instituto Nacional da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil.
Eur J Pediatr. 2021 May;180(5):1423-1430. doi: 10.1007/s00431-020-03912-0. Epub 2021 Jan 3.
This cohort study evaluated the nutritional supply in 78 very preterm newborns, with 20.5% developing bronchopulmonary dysplasia (BPD). This work aimed to evaluate the nutritional intake and the calorie/protein ratio received in the first 4 weeks of life. Anthropometric measures at birth and term age, the weight at each of the first 4 weeks of life, and the feeding practices were registered. The mean gestational age and birth weight were lower in those who developed BPD. At term age, head circumference and length Z-scores were significantly lower in newborns with BPD, who started enteral feeding and reached full diet later, staying longer in parenteral nutrition. The protein rate received by all newborns was similar, whether developing BPD or not, but those who developed BPD received significantly lower fluid volume and calorie rates after the second week. The daily calorie/protein ratio (30 kcal/1-g protein) was reached by 88.7% of the newborns who did not develop BPD in the third week, with those who developed BPD receiving less than this ratio until the second week, persisting in 56.3% of them on the fourth week.Conclusion: A calorie/protein ratio below that recommended for growth was found in preterm newborns who developed BPD, and providing nutrition for these newborns remains a challenge. What is Known: • The importance of preterm newborn nutrition is well known. • Early nutritional support may avoid severe BPD. What is New: • Newborns who developed BPD received a calorie/protein ratio below that recommended for preterm newborns' growth during the first 2 weeks of life, lasting until the fourth week in most of these newborns.
这项队列研究评估了 78 名极早产儿的营养供应情况，其中 20.5%发生支气管肺发育不良 (BPD)。本研究旨在评估生命最初 4 周的营养摄入量和热量/蛋白质比值。记录了出生时和矫正胎龄时的人体测量指标、生命最初 4 周的每个时间点的体重以及喂养方式。患有 BPD 的新生儿的平均胎龄和出生体重较低。在矫正胎龄时，患有 BPD 的新生儿的头围和长度 Z 评分明显较低，他们更早开始肠内喂养，达到全肠内喂养的时间较晚，更长时间接受肠外营养。所有新生儿接受的蛋白质比例相似，无论是否发生 BPD，但发生 BPD 的新生儿在第二周后接受的液体量和热量比例明显较低。88.7%未发生 BPD 的新生儿在第三周达到了每日热量/蛋白质比值（30kcal/1g 蛋白质），而发生 BPD 的新生儿在第二周前接受的比值低于该值，其中 56.3%的新生儿在第四周仍低于该值。结论：发生 BPD 的早产儿接受的热量/蛋白质比值低于推荐的生长比值，为这些新生儿提供营养仍然是一个挑战。已知内容：• 早产儿营养的重要性是众所周知的。• 早期营养支持可能避免严重的 BPD。新内容：• 生命最初 2 周内，发生 BPD 的新生儿接受的热量/蛋白质比值低于推荐的早产儿生长比值，其中大多数新生儿在第四周仍低于该值。
