Early Nutrition and Growth until the Corrected Age of 2 Years in Extremely Preterm Infants

Abstract

Background: Extremely preterm birth is associated with a high risk of extrauterine growth retardation, which has been linked with adverse developmental outcomes. Objective: We investigated whether nutritional management during the first 7 days of life affects growth patterns until the corrected age of 2 years in extremely preterm infants. Study Design: A retrospective study of 78 extremely preterm (<28 weeks' gestation) neonates was conducted. Data regarding parenteral and enteral intake of energy, protein, lipids, and carbohydrates during the first 7 days of life were collected from patient records. The outcome measures included weight, height, and head circumference with Z scores at term-equivalent age and the corrected ages of 1 and 2 years. Analyses were performed with hierarchical-linear mixed models. Results: Nutritional intake during the first week of life did not reach the current recommendations. The total energy intake during the first 7 days of life was statistically significantly associated with weight, length, and head circumference until the corrected age of 2 years after adjusting for potential confounding factors. Individual macronutrient intake displayed no association with growth patterns. Conclusions: Energy intake during the first 7 days of life is associated with growth until the corrected age of 2 years. These results provide support for the aggressive early nutritional management of extremely preterm infants.

Prematurity With Extrauterine Growth Restriction Increases the Risk of Higher Levels of Glucose, Low-Grade of Inflammation and Hypertension in Prepubertal Children

“…Improvements in neonatal care and more aggressive nutritional strategies have aimed to promote postnatal growth (32,33) and improve neurodevelopment outcomes (33)(34)(35). However, these nutritional interventions might also be associated with other adverse health consequences (7).…”

Calorie intake is associated with weight gain during transition phase of nutrition in female extremely low birth weight infants

“…Optimal early nutrition in preterm infants has been associated with better growth and neurodevelopmental outcomes. The total energy intake during the first 7 days of life is positively correlated with improved growth parameters until the corrected age of 2 years [1]. Coviello et al found a positive relationship between the initial 4 weeks of nutrition, with neurodevelopment, and white matter maturation at term equivalent age (TEA) in preterm infants < 31 weeks of gestation [2].…”

Long-term effects on growth of an energy-enhanced parenteral nutrition in preterm newborn: A quasi-experimental study

“…In this model, we considered some conditions that could affect infant growth. Previous studies in similar setting do not report R-squared values [21,[26][27][28][29]. Bonsante et al reported R-squared value of their linear regression analysis [7].…”

“…were due to protein or energy intake [25][26][27]. Unlike previous trials, our study was designed to assess the effects on long-term growth of two PN protocols, different for energy intakes but similar for protein intakes.…”