Identifying Malnutrition in Preterm and Neonatal Populations: Recommended Indicators

Goldberg, Dena; Becker, Patricia J.; Brigham, Katherine; Carlson, Susan; Fleck, Laura; Gollins, Laura; Sandrock, Maura; Fullmer, Michell; Poots, Holly A. Van

doi:10.1016/j.jand.2017.10.006

Cited by 129 publications

(148 citation statements)

References 96 publications

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“…The recent publication of criteria for the diagnosis of malnutrition in preterm babies and neonates by the Academy of Nutrition and Dietetics and the American Society for Parenteral and Enteral Nutrition, means that the diagnosis of malnourished neonates is standardised internationally. 11 This increases awareness of malnutrition in preterm babies and also the possibility of improving the level of diagnosis related reimbursement the hospital receives if the word "malnutrition" is written in the clinical notes by a dietitian and picked up by clinical coders. While a diagnosis of malnutrition may not increase the reimbursement for most very preterm babies during the birth episode of care, the addition of malnutrition to the code list can make a funding difference for late preterm, term surgical or cardiac neonates.…”

Section: Discussionmentioning

confidence: 99%

“…Neonatal dietitians have this knowledge and the skills to help prevent malnutrition through the development of standardised feeding guidelines, screening, identifying babies at risk and targeting nutritional strategies to prevent malnutrition occurring. 10,11 A previous survey of neonatal units in Australian and New Zealand conducted 10 years ago reported wide variation in enteral feeding practices and identified that over 50% of units did not have written enteral feeding guidelines. Many neonatal units did not have access to a neonatal dietitian.…”

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confidence: 99%

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Neonatal dietitian resourcing and roles in New Zealand and Australia: A survey of current practice

Cormack

Oliver

Farrent

et al. 2019

Nutrition & Dietetics

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Aim: Dietitian-led implementation of evidence-based nutrition support practices improves nutrient intakes, clinical outcomes and growth, decreases length of stay and related costs, and reduces intravenous nutrition costs and prescription errors. We aimed to investigate current neonatal dietitian resourcing and roles in New Zealand and Australian neonatal units, and to compare this with dietitian workforce recommendations and previously reported survey data. Methods: A two-part electronic survey was emailed to 50 Australasian Neonatal Dietitians Network members and other dietitians working in neonatal intensive care or special care baby units in New Zealand and Australia. The survey ran from July to October 2018. Descriptive statistics were used to examine the distribution of responses. Responses were compared with other similar surveys and British Dietetic Association workforce recommendations.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Neonatal dietitian resourcing and roles in New Zealand and Australia: A survey of current practice

Cormack

Oliver

Farrent

et al. 2019

Nutrition & Dietetics

View full text Add to dashboard Cite

show abstract

“…In 2014, the same 2 organizations published a consensus statement for pediatric clinical characteristics, and a validation study is in process for these 2 sets of criteria . In 2018, a workgroup from the Academy published neonatal malnutrition clinical characteristics …”

Section: Diagnosismentioning

confidence: 99%

mentioning

confidence: 99%

“…Protein calorie malnutrition (PCM) affects adults, children, and infants in the United States and globally. PCM is characterized by muscle and/or fat wasting, weight loss, underweight, poor growth, reduced functional ability, and/or micronutrient deficiencies . The etiology of PCM is multifactorial, most often related to poor nutrient intake or assimilation and diseases or conditions that cause inflammation, hypermetabolism, or malabsorption …”

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confidence: 99%

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Coding for Malnutrition in the Hospital: Does It Change Reimbursement?

Doley

Phillips

2019

Nut in Clin Prac

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Protein calorie malnutrition (PCM) is prevalent in the acute care setting, affecting up to 50% of hospitalized patients. PCM is associated with poor outcomes, including increased hospital and intensive care unit length of stay, hospital readmission rates, incidence of pressure injuries and nosocomial infections, and mortality. PCM is a financial burden on the healthcare system through direct costs related to treatment as well as indirect costs related to poorer outcomes and complications. Medical coding for malnutrition after a patient's hospital stay is poorly representative of the actual prevalence of malnutrition, as only a small percentage of these hospital stays are coded for PCM. Improvements in identification and coding of malnutrition can result in significant increases in hospital reimbursement, which can in part help defray increased costs associated with the condition. (Nutr Clin Pract. 2019;34:823-831)

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Higher Energy, Lipid, and Carbohydrate Provision to Very Low‐Birth‐Weight Infants Is Differentially Associated With Neurodevelopment at 18 Months, Despite Consistent Improvements in Weight Gain

Bishara

Asbury

et al. 2021

J Parenter Enteral Nutr

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Background:The impact of suboptimal intakes on neurodevelopment of very low-birth-weight (VLBW, <1500 g) infants, particularly those born small for gestational age, <26 weeks, <1000 g, or with morbidities is not well defined. We investigated how macronutrient/energy intakes are associated with growth and neurodevelopment among VLBW infants, adjusted for the aforementioned vulnerabilities. Our hypothesis was that higher nutrient intakes would be positively associated with weight gain and neurodevelopment. Methods: Daily macronutrient/energy intakes and weekly weights from birth until 36 +0 weeks were collected prospectively from VLBW infants (n = 302) enrolled in a previous trial (ISRCTN35317141). Neurodevelopment was assessed by the Bayley-III at 18 months' corrected gestational age. Relationships between quartiles of macronutrient/energy intakes, growth, and neurodevelopment were assessed. Results: Infants born <1000 g, <26 weeks, or with morbidities had lower nutrient intakes and slower growth than infants born ≥1000 g, ≥26 weeks, or with no morbidities, respectively (P < 0.05). Higher quartiles of energy, lipid, and carbohydrate intakes were positively associated with growth velocity (P = <0.0001-0.007); no association was observed for protein intake. Energy, protein-to-energy ratio and lipid intakes were associated with cognitive scores (P = 0.001-0.004); however, intakes within the second and third quartiles were generally associated with the highest cognitive scores. No nutrient intakes were associated with language or motor scores across the entire study period. Conclusion: Smaller, more immature VLBW infants and those with morbidity have the greatest risk of poor nutrition and growth. Increasing macronutrient/energy intakes are generally associated with improved weight gain, but not necessarily improved neurodevelopment.

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Identifying Malnutrition in Preterm and Neonatal Populations: Recommended Indicators

Cited by 129 publications

References 96 publications

Neonatal dietitian resourcing and roles in New Zealand and Australia: A survey of current practice

Neonatal dietitian resourcing and roles in New Zealand and Australia: A survey of current practice

Coding for Malnutrition in the Hospital: Does It Change Reimbursement?

Higher Energy, Lipid, and Carbohydrate Provision to Very Low‐Birth‐Weight Infants Is Differentially Associated With Neurodevelopment at 18 Months, Despite Consistent Improvements in Weight Gain

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