Lafeber Anne H, de Jong Roxanne C, Bosch Mark, van de Lagemaat Monique, van Veenendaal Nicole R, Aarnoudse-Moens Cornelieke S H, Boersma Bart, van Goudoever Johannes B, de Groof Femke
Department of Pediatrics and Neonatology, North West Clinics, Alkmaar, The Netherlands.
Emma Children's Hospital Department of Pediatrics, Amsterdam UMC, University of Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Pediatr Res. 2024 Oct;96(5):1258-1266. doi: 10.1038/s41390-024-03231-2. Epub 2024 May 20.
Moderate and late preterm infants (MLPTI) (gestational age 32 0/7-36 6/7 weeks), are at risk for suboptimal growth. This study evaluated adherence to nutritional recommendations until 6 months corrected age (CA), growth until 2 years CA, and associations between nutritional intake and growth until 2 years CA.
We prospectively collected nutritional intakes from 100 MLPTI during the first week of life and at 6 weeks, 3 months, and 6 months CA. Anthropometry was assessed at birth, discharge, term age, and at 6 weeks, 3 months, 6 months, 1 year, and 2 years CA.
On day 7, <40% reached nutritional recommendations. Thereafter, >80% reached protein recommendations until 6 months of life, but <60% reached energy recommendations. Weight z-scores increased from -0.44 at term-age to 0.59 at 3 months CA, but declined to -0.53 at 2 years CA on the TNO curves. No significant associations were found between nutritional intake and growth until 2 years CA.
No associations were demonstrated between nutritional intakes and growth until 2 years CA, despite not reaching recommended intakes. Despite high efforts to optimize growth, MLPTI find their own growth curve in the first 2 years of life.
This research is pioneering in identifying how nutrition influences growth in moderate and late preterm infants (MLPTI) up to 2 years corrected age (CA). MLPTI often do not meet the recommended protein and energy intake in their first week of life, suggesting that current guidelines might be too high. No association was demonstrated between nutritional intake and growth of MLPTI in the first 2 years of life. Initially, MLPTI show an increase in weight z-scores from term age up to 3 months CA but experience a decline in weight z-scores at 2 years CA, according to TNO growth charts.
中度和晚期早产儿（孕龄32⁰/₇ - 36⁶/₇周）存在生长发育欠佳的风险。本研究评估了这些婴儿至矫正年龄6个月时对营养建议的依从性、至矫正年龄2岁时的生长情况，以及至矫正年龄2岁时营养摄入与生长之间的关联。
我们前瞻性收集了100名中度和晚期早产儿出生后第一周、矫正年龄6周、3个月和6个月时的营养摄入量。在出生时、出院时、足月时以及矫正年龄6周、3个月、6个月、1岁和2岁时进行人体测量。
出生后第7天，不到40%的婴儿达到营养建议。此后，超过80%的婴儿至6个月龄时达到蛋白质建议摄入量，但只有不到60%的婴儿达到能量建议摄入量。根据TNO生长曲线，体重z评分从足月时的 -0.44增加至矫正年龄3个月时的0.59，但在矫正年龄2岁时降至 -0.53。至矫正年龄2岁时，未发现营养摄入与生长之间存在显著关联。
尽管未达到建议摄入量，但至矫正年龄2岁时，未发现营养摄入与生长之间存在关联。尽管为优化生长付出了巨大努力，但中度和晚期早产儿在出生后的头两年仍遵循自身的生长曲线。
本研究率先确定了营养如何影响中度和晚期早产儿至矫正年龄2岁时（CA）的生长。中度和晚期早产儿在出生后的第一周通常未达到建议的蛋白质和能量摄入量，这表明当前指南可能过高。在中度和晚期早产儿出生后的头两年，未发现营养摄入与生长之间存在关联。根据TNO生长图表，中度和晚期早产儿最初体重z评分从足月时开始增加，直至矫正年龄3个月，但在矫正年龄2岁时体重z评分下降。
