Abstract:Objective To investigate the relationship between early growth of preterm very low birth weight infant (VLBWI) and parenteral and enteral nutrition,so as to provide scientific basis for parenteral nutrition (PN) and enteral nutrition (EN) regimen in clinical practice. Methods All eligible VLBWIs were divided into two groups according to the change of Z-score (ΔWt SDS) between birth and correct gestational age at discharge for body weight:non-catch-down (NCD) group,ΔWt SDS≥-0.67;catch-down (CD) group:ΔWt SDS<-0.67.Clinical data were analyzed between the two groups. Results There were 92 cases in NCD group and 85 cases in CD group.No significant differences were found in incidence of maternal complications,birth anthropometric parameters (weight,length,head circumference) and relative anthropometric parameters Z-score between the two groups (P>0.05).The NCD group had better anthropometric parameters and relative anthropometric parameters Z-score than the CD group at discharge (P<0.05 or <0.01).The NCD group had lower incidence of bronchopulmonary dysplasia and parenteral nutrition associated cholestasis than the CD group (P<0.05).The NCD group had significant lower PN duration than the CD group (P<0.01).The NCD group had higher PN energy intake than the CD group from day 5 to day 7 (P<0.05).However,the NCD group had lower PN energy intake than the CD group from week 2 to week 6 (P<0.05).The NCD group had higher EN feeding volume from day 5 to week 6 (P<0.05 or <0.01).The NCD group had higher EN and PN total protein intake from day 5 to week 5 (P<0.05). Conclusion Adequate PN lipid and energy intake during the first week of life,enhanced EN feeding volume could shorten PN duration and improve early growth of VLBWI.
余慕雪,郭楚怡,刘王凯,庄思齐. 早产极低出生体重儿早期生长与肠外肠内营养关系研究分析[J]. 中国儿童保健杂志, 2017, 25(8): 759-762.
YU Mu-xue,GUO Chu-yi,LIU Wang-kai,ZHUANG Si-qi. Relationship between early growth of preterm very low birth weight infants and parenteral and enteral nutrition. journal1, 2017, 25(8): 759-762.
[1] Fanaro S.Feeding intolerance in the preterm infant[J].Early Hum Dev,2013,89(Suppl 2):13-20. [2] Koletzko B,Poindexter B,Uauy R.Nutritional care of preterm infants:scientific basis and practical guidelines[M].Switzerland:Karger,2014:1-314. [3] Horbar JD,Ehrenkranz RA,Badger GJ,et al.Weight growth velocity and postnatal growth failure in infants 501 to 1500 grams:2000-2013[J].Pediatrics,2015,136(1):e84-e92. [4] Corpeleijn WE,Kouwenhoven SM,van Goudoever JB.Optimal growth of preterm infants[J].World Rev Nutr Diet,2013,106:149-155. [5] Ong K.Association between postnatal catch-up growth and obesity in childhood:prospective cohort study[J].BMJ,2000,320(7244):1244. [6] Fenton TR,Kim JH.A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants[J].BMC Pediatr,2013,13:59. [7] Salama GS,Kaabneh MA,Almasaeed MN,et al.Intravenous lipids for preterm infants:a review[J].Clin Med Insights Pediatr,2015,9:25-36. [8] Dit TS,Kermorvant-Duchemin E,Huon C,et al.Early lipid supply and neurological development at one year in very low birth weight (VLBW) preterm infants[J].Early Hum Dev,2012,88(Suppl 1):25-29. [9] Sourabh D,Balpreet S,Lorraine C,et al.Guidelines for feeding very low birth weight infants[J].Nutrients,2015,7(1):423-442. [10] Working GOPC,Working GONC,Working GONS.CSPEN guidelines for nutrition support in neonates[J].Asia Pac J Clin Nutr,2013,22(4):655-663. [11] Morgan J,Young L,Mcguire W.Slow advancement of enteral feed volumes to prevent necrotising enterocolitis in very low birth weight infants[J].Cochrane Database Syst Rev,2015(10):D1241. [12] Agostoni C,Buonocore G,Carnielli VP,et al.Enteral nutrient supply for preterm infants:commentary from the European Society of Paediatric Gastroenterology,Hepatology and Nutrition Committee on Nutrition[J].J Pediatr Gastroenterol Nutr,2010,50(1):85-91. [13] Uberos J,Lardón-Fernández M,Machado-Casas I,et al.Nutrition in extremely low birth weight infants:impact on bronchopulmonary dysplasia[J].Minerva Pediatrica,2016,68(6):419-426. [14] Shlomai NO,Patole S.Nutrition in preterm infants with bronchopulmonary dysplasia[M].Springer Netherlands,2013,421-439. [15] Gianni ML,Roggero P,Colnaghi MR,et al.The role of nutrition in promoting growth in pre-term infants with bronchopulmonary dysplasia:a prospective non-randomised interventional cohort study[J].BMC Pediatr,2014,14:235. [16] Yan W,Hong L,Wang Y,et al.Retrospective dual-center study of parenteral nutrition-associated cholestasis in premature neonates[J].Nutr Clin Pract,2017,2013021780.doi:10.1177/0884533616687532. [17] Repa A,Lochmann R,Unterasinger L,et al.Aggressive nutrition in extremely low birth weight infants:impact on parenteral nutrition associated cholestasis and growth[J].Peer J,2016,4:e2483