Shilpee Raturi
KK Womens and Children’s Hospital, Singapore
Title: Nutritional intake and growth velocity in preterm extremely low birth weight infants in Asia: Are we doing enough?
Biography
Biography: Shilpee Raturi
Abstract
Aims: The aims of this study were to describe nutritional practices among preterm extremely low birth weight (ELBW) infants and their impact on growth and to compare differences in nutritional intervention and co-morbidities between those with limited growth velocity (GV<25th percentile) and those with GV³25th percentile.
Methods: A prospective cohort study was conducted to assess total protein and energy intake for week 1, days 14, 21 and 28 of life. Post-natal growth was calculated by measuring GV using an exponential model. Univariable analysis was applied to identify the potential risk factors associated with poor GV at day 28 and at discharge from hospital.
Results: The median GV from birth to day 28 was 9.84g/kg/day and 11.87g/kg/day for GV from birth to discharge. Increased protein and energy intake was associated with higher GV at discharge. Hypotension needing inotropes, necrotizing enterocolitis (NEC), patent ductus arteriosus and chronic lung disease were significantly associated with reduced GV at discharge. Infants with NEC, hypotension needing inotropes and sepsis took a significantly longer time to achieve full enteral nutrition. A longer time to attain full enteral feeds was associated with slower GV at discharge. Small-for-gestational-age babies increased from 22% at birth to 66.6% at discharge.
Conclusions: GV at discharge was positively correlated with increasing protein and energy intake in the first 28 days and adversely affected by the presence of neonatal morbidities. There was strong evidence of extra-uterine growth restriction, with the majority of preterm ELBW infants having lower z scores at discharge compared to at birth.