Nutrient intakes independently affect growth in extremely preterm infants: results from a population-based study

Sjöström, Elisabeth Stoltz; Öhlund, Inger; Ahlsson, Fredrik; Engström, Eva; Fellman, Vineta; Hellström, Ann; Källén, Karin; Norman, Mikael; Olhager, Elisabeth; Serenius, Fredrik; Domellöf, Magnus

doi:10.1111/apa.12359

Cited by 55 publications

(71 citation statements)

References 29 publications

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“…Nutritional supply is essential for the prevention of growth failure of premature babies: insufficient energy and macronutrients intake may lead to unbalanced growth, altered neurological development and increased risk of morbidity [33]. …”

Section: Discussionmentioning

confidence: 99%

Pattern of drug use among preterm neonates: results from an Italian neonatal intensive care unit

et al. 2017

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BackgroundDrug use in preterm neonates admitted to Neonatal Intensive Care Unit (NICU) has been investigated, so far, in terms of unauthorized or off-label use; very little is known on the use of combinations of different active substances, which is frequently required in this population (prophylaxis of infections, treatment of concomitant diseases). The aim of this study was to describe the most common patterns of drug use in an Italian NICU, focusing on those with nephrotoxic potential.MethodsMedical records of preterm neonates (<37 weeks of gestational age) weighing less than 1,500 g at birth and admitted to an Italian NICU were scrutinized in a 3-year retrospective investigation. Analysis included drug exposure, duration of therapies, co-administration of drugs with potential renal side effects; also daily protein supplement was calculated from parenteral nutrition.ResultsA cohort of 159 preterm neonates was selected; 68 were born weighing less than 1,000 g (extremely low birth weight infants, ELBW, Group A), 91 weighed between 1,000 and 1,500 g at birth (Group B). Compared to Group B, neonates of Group A were more likely to receive pharmacological treatments: the most used drugs were antibiotics (especially ampicillin and amikacin, p = .07 and p < .001, respectively), antifungals (especially fluconazole, p < .001), and diuretics (especially furosemide, p < .001). Analysis of co-administration of drugs with potential nephrotoxicity showed ampicillin and amikacin as the most reported combination (94.1% of Group A and 31.9% of Group B), the combination of furosemide with antibacterials (ampicillin or amikacin) was also frequently reported, with average period of combination shorter than 2 days.ConclusionsELBW infants were exposed to a higher number of drugs compared to other neonates and were more likely to receive associations of drugs with nephrotoxic potential (e.g. furosemide and amikacin), though only for short cycles. Further studies should evaluate the safety profile (especially potential renal side effects) related to most commonly used combinations.

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Section: Discussionmentioning

confidence: 99%

Pattern of drug use among preterm neonates: results from an Italian neonatal intensive care unit

et al. 2017

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“…18 Greater protein and caloric intake during the first 4 postnatal weeks has been shown to increase head circumference at both 28 days of life and 36 weeks postmenstrual age among infants < 29 weeks gestation. 19 Similarly, protein and fat intake during the first 10 postnatal weeks correlate positively with head growth in those born less than 27 weeks 20 , and very low birth weight infants experienced improved head growth following strategies implemented to increase caloric and protein intake. 21 In extremely preterm infants, particularly those critically-ill, providing adequate nutrition to support growth is often limited by fluid restriction, inability to use the gut for feeding, or feeding tolerance, resulting in postnatal growth restriction similar to that experienced by infants in this study.…”

Section: Discussionmentioning

confidence: 99%

Neurodevelopmental outcomes in postnatal growth-restricted preterm infants with postnatal head-sparing

et al. 2016

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Objective To compare neurodevelopmental outcomes in postnatal growth-restricted infants born < 29 weeks with and without postnatal head-sparing. Study Design We analyzed developmental outcomes at 2 years of age among postnatally growth-restricted infants with and without head-sparing. The primary outcome was Bayley III cognitive composite score; secondary outcomes included Bayley III motor composite score, moderate/severe cerebral palsy, GMFCS level ≥2, and presence or absence of neurodevelopmental impairment (NDI). Results Of 1098 infants evaluated at 18–22 months, 658 were postnatally growth-restricted, of whom 301 had head-sparing. In the multivariate model including independent risk factors for poor growth and poor developmental outcome, infants with head-sparing had higher adjusted motor composite scores (mean difference 4.65, p<0.01), but no differences in other neurodevelopmental outcomes. Conclusion Postnatal head-sparing is associated with improved neurodevelopmental outcome in extremely preterm infants, specifically Bayley III motor scores, but whether beneficial effects of PHS persist later in life is unknown.

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“…The relation between nutrition and growth in the entire EXPRESS cohort (not only those undergoing PDA surgery) has recently been described. Poor macronutrient and energy intakes were found to be independent predictors of suboptimal growth, also after adjusting for disease‐related factors such as mechanical ventilation and postnatal corticosteroid therapy .…”

Section: Discussionmentioning

confidence: 93%

“…Energy and macronutrient intakes from parenteral and enteral nutritional products were calculated using data from the manufacturers and from breast milk analyses . Standard practice at all participating hospitals was to feed infants maternal breast milk or, if not available, donated breast milk up to a postmenstrual age of 32–35 weeks . Fresh maternal milk was given to the infant as soon as it was available, and as soon enteral feedings were tolerated.…”

Section: Methodsmentioning

confidence: 99%

“…After sampling for analyses of nutritional contents, all donated breast milk was routinely heat‐treated using the Holder pasteurisation (62.5°C for 30 min). Breast milk analyses were performed at Eurofins Steins Laboratory AB (Jönköping, Sweden), using mid‐infrared analysis (MilkoScan 4000) . During the 2004–2007 study period, breast milk was routinely analysed in five of the seven university hospitals.…”

Section: Methodsmentioning

confidence: 99%

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Perioperative nutrition in extremely preterm infants undergoing surgical treatment for patent ductus arteriosus is suboptimal

et al. 2013

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Nutrient intakes independently affect growth in extremely preterm infants: results from a population-based study

Cited by 55 publications

References 29 publications

Pattern of drug use among preterm neonates: results from an Italian neonatal intensive care unit

Pattern of drug use among preterm neonates: results from an Italian neonatal intensive care unit

Neurodevelopmental outcomes in postnatal growth-restricted preterm infants with postnatal head-sparing

Perioperative nutrition in extremely preterm infants undergoing surgical treatment for patent ductus arteriosus is suboptimal

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