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出院后早产儿重要微量营养素补充概述:呼吁达成共识

Overview of Important Micronutrients Supplementation in Preterm Infants after Discharge: A Call for Consensus.

作者信息

Ilardi Laura, Proto Alice, Ceroni Federica, Morniroli Daniela, Martinelli Stefano, Mosca Fabio, Giannì Maria Lorella

机构信息

Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy.

Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.

出版信息

Life (Basel). 2021 Apr 10;11(4):331. doi: 10.3390/life11040331.

Abstract

Preterm infants have a lower level of nutrient body stores and immature body systems, resulting in a higher risk of malnutrition. Imbalanced complementary feeding could lead to further risk of nutritional deficits and excesses. However, evidence on their nutritional requirements following hospital discharge is limited. When planning complementary feeding, appropriate micronutrient intake should be considered for their critical role in supporting various body functions. This narrative review summarizes the need for iron, zinc, vitamin D, calcium, phosphate and long-chain polyunsaturated fatty acids (LCPUFAs) supplementation in preterm infants during complementary feeding. Regarding iron and vitamin D, the scientific community is reaching an agreement on supplementation in some categories of prematures. On the contrary, there is still not enough evidence to detail possible recommendations for LCPUFAs, zinc, calcium and phosphorus supplementation. However, these micronutrients are paramount for preterms' health: LCPUFAs can promote retinal and brain development while calcium and phosphorus supplementation is essential to prevent preterms' metabolic bone disease (MBD). Waiting for a consensus on these micronutrients, it is clear how the knowledge of the heterogeneity of the prematures population can help adjust the nutritional planning regarding the growth rate, comorbidities and comprehensive clinical history of the preterm infant.

摘要

早产儿的营养储备水平较低,身体系统不成熟,导致营养不良风险较高。不均衡的辅食添加可能会进一步增加营养缺乏和过剩的风险。然而,关于他们出院后营养需求的证据有限。在规划辅食添加时,应考虑适当的微量营养素摄入,因为它们在支持身体各种功能方面起着关键作用。本叙述性综述总结了早产儿在辅食添加期间补充铁、锌、维生素D、钙、磷和长链多不饱和脂肪酸(LCPUFAs)的必要性。关于铁和维生素D,科学界在某些类别的早产儿补充方面已达成共识。相反,对于补充LCPUFAs、锌、钙和磷,仍没有足够的证据来详细说明可能的建议。然而,这些微量营养素对早产儿的健康至关重要:LCPUFAs可促进视网膜和大脑发育,而补充钙和磷对于预防早产儿的代谢性骨病(MBD)至关重要。在等待关于这些微量营养素的共识时,很明显,了解早产儿群体的异质性有助于根据早产儿的生长速度、合并症和全面临床病史调整营养规划。

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