Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
Nestle Nutr Inst Workshop Ser. 2021;96:130-137. doi: 10.1159/000519393. Epub 2022 May 10.
Deficiency or excess of specific micronutrients is common in preterm infants and can have many effects on health outcomes, ranging from life-threatening electrolyte disturbances to long-term effects on growth, brain development, bone health, and the risk of retinopathy of prematurity (ROP). Iron supplementation of low birth weight infants reduces the risk of behavioral problems. However, due to the risk of adverse effects, iron supplementation of very preterm infants in the NICU should be individualized, considering birth weight, postnatal age, diet, and serum ferritin concentrations. Sodium intakes should be minimized during the first 3 days of life in very preterm infants to avoid hypernatremia. However, after 4 days of age, sodium supplements can reduce hyponatremia and improve growth. Adequate parenteral and enteral calcium and phosphorus intakes are crucial for the prevention of osteopenia of prematurity. Screening of serum phosphate concentrations is useful. Deficiencies of docosahexaenoic acid (DHA) and arachidonic acid (AA) are frequently observed in extremely preterm infants. A recent Swedish study suggests that combined DHA and AA supplementation may reduce the risk of severe ROP. When prescribing enteral and parenteral nutrition for preterm infants, it is important to consider micronutrients. Many preterm infants will need different micronutrient supplements.
微量营养素的缺乏或过量在早产儿中很常见，可能对健康结果产生多种影响，从危及生命的电解质紊乱到对生长、大脑发育、骨骼健康和早产儿视网膜病变 (ROP) 的风险的长期影响。补充铁元素可以降低低出生体重儿发生行为问题的风险。然而，由于存在不良反应的风险，NICU 中非常早产儿的铁补充应个体化，考虑出生体重、出生后年龄、饮食和血清铁蛋白浓度。在非常早产儿的生命最初 3 天内，钠摄入量应最小化，以避免高钠血症。然而，在 4 天后，钠补充可以减少低钠血症并改善生长。充足的钙和磷的肠外和肠内摄入量对于预防早产儿骨质疏松症至关重要。监测血清磷酸盐浓度很有用。极早产儿中经常观察到二十二碳六烯酸 (DHA) 和花生四烯酸 (AA) 的缺乏。最近的一项瑞典研究表明，联合补充 DHA 和 AA 可能降低严重 ROP 的风险。在为早产儿开具肠内和肠外营养处方时，考虑微量营养素很重要。许多早产儿需要不同的微量营养素补充。
