Rossholt Madelaine Eloranta, Bratlie Marianne, Wendel Kristina, Aas Marlen Fossan, Gunnarsdottir Gunnthorunn, Fugelseth Drude, Stiris Tom, Domellöf Magnus, Størdal Ketil, Moltu Sissel Jennifer
Department of Neonatal Intensive Care, Oslo University Hospital, Norway; Department of Pediatrics and Adolescence Medicine, Oslo University Hospital, Norway; Institute of Clinical Medicine, University of Oslo, Norway.
Department of Neonatal Intensive Care, Oslo University Hospital, Norway; Department of Pediatrics and Adolescence Medicine, Oslo University Hospital, Norway; Institute of Clinical Medicine, University of Oslo, Norway.
Clin Nutr ESPEN. 2023 Feb;53:251-259. doi: 10.1016/j.clnesp.2022.12.024. Epub 2022 Dec 28.
BACKGROUND & AIMS: Nutrition is a cornerstone of postnatal care to prevent compromised growth and support short- and long-term health outcomes in preterm infants. We aimed to evaluate nutritional intakes and growth among infants <29 weeks gestation after implementation of a standardized feeding protocol.
This is an observational cohort secondary analysis of data from the ImNuT study (Immature, Nutrition Therapy, NCT03555019). To reduce variations in nutritional practice and ensure accommodation to current guidelines, we developed a standardized feeding protocol. Detailed information on actual nutritional intakes, growth and biochemistry was prospectively collected and assessed from birth to 36 weeks postmenstrual age (PMA).
Median (range) gestational age and birth weight were 26 (22-28) weeks and 798 (444-1485) g. Energy and macronutrient intakes progressively increased from birth through transition to exclusive enteral feeds. Parenteral nutrition was weaned at median (IQR) day 11 (9, 14) when nutritional requirements were met by exclusively enteral feeds. Infants exhibited a median (IQR) weight loss of 7.8% (5.7, 11.6) and regained birth weight by day 8 (7, 11). Average velocity in weight, length and head circumference from birth to 36 weeks PMA were in accordance with target growth rates; median (IQR) 15.8 (14.7, 17.7) g/kg/d, 1.1 (0.98, 1.3) cm/week and 0.82 (0.83, 0.89) cm/week. At 36 weeks PMA, only 3% of infants exhibited moderate growth faltering (decline in weigh-for-age z score >1.2 from birth), and none severe.
In infants <29 weeks gestation, the standardized feeding protocol was well tolerated. Nutrient intakes and growth were close to recommendations.
营养是产后护理的基石，对于预防早产儿生长发育受损及支持其短期和长期健康结局至关重要。我们旨在评估实施标准化喂养方案后孕周小于29周的婴儿的营养摄入及生长情况。
这是一项对ImNuT研究（不成熟儿营养治疗，NCT03555019）数据的观察性队列二次分析。为减少营养实践中的差异并确保符合当前指南，我们制定了标准化喂养方案。前瞻性收集并评估了从出生至孕龄36周（PMA）的实际营养摄入、生长及生化方面的详细信息。
中位（范围）孕周和出生体重分别为26（22 - 28）周和798（444 - 1485）克。从出生到过渡至完全肠内喂养，能量和宏量营养素摄入量逐渐增加。当完全肠内喂养满足营养需求时，肠外营养在中位（IQR）第11天（9，14）停用。婴儿体重中位（IQR）减轻7.8%（5.7，11.6），并在第8天（7，11）恢复出生体重。从出生到孕龄36周，体重、身长和头围的平均增长速度符合目标生长速率；中位（IQR）分别为15.8（14.7，17.7）克/千克/天、1.1（0.98，1.3）厘米/周和（0.83，0.89）厘米/周。在孕龄36周时，只有3%的婴儿出现中度生长迟缓（年龄别体重Z评分较出生时下降>1.2），无重度生长迟缓。
对于孕周小于29周的婴儿，标准化喂养方案耐受性良好。营养摄入和生长情况接近推荐水平。
