Double-blinded randomized controlled trial of optimizing nutrition in preterm very low birth weight infants: Bayley scores at 18–38 months of age

Reis, Jordan D; Tolentino-Plata, Kristine; Caraig, Maria; Heyne, Roy J.; Rosenfeld, Charles R.; Brown, L. Steven; Brion, Luc P.

doi:10.1038/s41372-022-01572-6

Cited by 4 publications

(1 citation statement)

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“…Our results indicate that early achievement of a positive energy –protein balance is crucial to prevent extrauterine growth restriction; however, it is a two-centre study with a relatively small sample size, and we consider this to be another limitation of this research. However, this is an original study comparing between and within separate GA subcohorts with a sample size well larger than the one of similar studies [ 21 , 66 , 67 ]. Although a third limitation could be the presented collected intake data on 3 days only, we have collected all days’ data of all 174 patients as is indicated in Table 3 and Table 4 .…”

Section: Discussionmentioning

confidence: 99%

The Impact of Estimated Energy and Protein Balances on Extrauterine Growth in Preterm Infants

Lygerou,

Ilia,

Briassoulis

et al. 2023

Nutrients

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Background: Nutritional support of preterm infants remains a field of debate in the literature and clinical practice varies significantly. Adequate nutrition should promote growth and aim for optimal later neurodevelopment. However, it is often impaired by prematurity-associated morbidity and the physiologic immaturity of preterm infants. This study assessed the impact of energy and macronutrient provision on growth velocity and outcome and explored differences attributed to the heterogeneity of the preterm population. Methods: We retrospectively collected clinical and nutritional data from neonates hospitalized in two separate Neonatal Intensive Care Units (NICUs). Estimated energy and protein balance were calculated based on the ESPGHAN guidelines and their association with the growth outcome was explored. Growth assessment was based on somatometry Delta (Δ) z-scores at discharge. Results: In total, 174 neonates were included in the study. By day 14, most preterm infants were exclusively enterally fed, whereas there were infants in the <28 and 28–31+6 subgroups fed exclusively parenterally. Energy balance was positive for all gestational age (GA) subgroups except for those born <28 weeks. Protein balance was consistently positive for extremely premature but negative for late preterms. Cumulative substrates provisions were strong predictors of a positive energy or protein balance in the <34 weeks GA preterms on days 14 (ROC analyses, p < 0.001) and 7 (p < 0.05). A higher GA (p = 0.013) and enteral nutrition (p = 0.005) were additional predictors of a positive energy balance. All GA subgroups had a negative Δ z-score of weight at discharge. In the <34 GA subcohorts, a positive protein balance on day 14 (p = 0.009) and a short time to regain birth weight (exp(B) 3.1 (p = 0.004) were independently associated with a positive Δ z-score of weight at discharge. Conclusions: Early achievement of a positive energy and protein balance, based on the ESPGHAN guidelines, is crucial to ensure optimal postnatal growth and prevent extrauterine growth restriction, a relatively common occurrence in preterm infants.

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Section: Discussionmentioning

confidence: 99%