Division of Pediatric Gastroenterology, Peyton Manning Children's Hospital, Indianapolis, Indiana, USA.
Division of Neonatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Nutr Clin Pract. 2021 Dec;36(6):1215-1219. doi: 10.1002/ncp.10727. Epub 2021 Jul 10.
Infants born large for gestational age (LGA) not exhibiting catch-down growth (a decline of weight z-score by 1) have a higher likelihood of future obesity. We aimed to identify the term LGA infants in our neonatal intensive care unit (NICU) and document nutrition interventions that may influence growth. Our 10-year retrospective review identified 47 term LGA infants who had a NICU length of stay (LOS) ≥7 days. We obtained demographic data, nutrition interventions in the NICU, and data regarding growth patterns. Of the 47 infants, 31 (66%), demonstrated catch-down growth at discharge at ≥7 days. Overall, 39 of 47 patients (83%) received interventions during their NICU stay, including 32 (69%) who had nasogastric tubes placed, and 24 (51%) had formula fortification to augment weight gain. Among patients with LOS ≥14 days, 23 of 23 patients without catch-down growth and four of five patients with catch-down growth had nutrition interventions performed. Of the overall population, only 38% of those who did not demonstrate catch-down growth had an LOS of ≥14 days vs 77% of all infants that did exhibit catch-down growth (P = .01). Our data suggest that nutrition interventions in LGA infants are common in the NICU. Our study highlights the need for further clinical studies to help direct care in this population of infants.
出生时为巨大儿（LGA）且未出现追赶性生长（体重 z 评分下降 1）的婴儿将来肥胖的可能性更高。我们旨在确定我们新生儿重症监护病房（NICU）中患有 LGA 的婴儿，并记录可能影响生长的营养干预措施。我们的 10 年回顾性研究确定了 47 名患有 NICU 住院时间（LOS）≥7 天的足月 LGA 婴儿。我们获得了人口统计学数据、NICU 中的营养干预措施以及生长模式的数据。在 47 名婴儿中，31 名（66%）在≥7 天的出院时出现追赶性生长。总体而言，47 名患者中有 39 名（83%）在 NICU 期间接受了干预措施，包括 32 名（69%）放置了鼻胃管，以及 24 名（51%）通过配方奶强化来促进体重增加。在 LOS≥14 天的患者中，23 名未出现追赶性生长的患者和 5 名出现追赶性生长的患者中均有营养干预措施。在所有人群中，仅 38%的未出现追赶性生长的婴儿的 LOS≥14 天，而所有出现追赶性生长的婴儿中，这一比例为 77%（P=0.01）。我们的数据表明，LGA 婴儿在 NICU 中接受营养干预措施很常见。我们的研究强调需要进一步的临床研究来帮助指导这一婴儿群体的护理。
