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Early energy and protein intakes and associations with growth, BPD and ROP in extremely preterm infants
Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.ORCID iD: 0000-0002-4649-0653
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2019 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 38, no 3, p. 1289-1295Article in journal (Refereed) Published
Abstract [en]

Background & aim: Extremely preterm infants face substantial neonatal morbidity. Nutrition is important to promote optimal growth and organ development in order to reduce late neonatal complications. The aim of this study was to examine the associations of early nutritional intakes on growth and risks of bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) in a high-risk population.

Methods: This population-based cohort study includes infants born before 27 0/7 weeks of gestational age without severe malformations and surviving ≥10 days. Intake of energy and protein on postnatal days 4–6 and association with weight standard deviation score (WSDS) from birth to day 7, as well as intakes of energy and protein on postnatal days 4–6 and 7 to 27, respectively, and association with composite outcome of death and BPD and separate outcomes of BPD and ROP were examined, and adjusted for potential confounders.

Results: The cohort comprised 296 infants with a median gestational age of 25 3/7 weeks. Expressed as daily intakes, every additional 10 kcal/kg/d of energy during days 4–6 was associated with 0.08 higher WSDS on day 7 (95% CI 0.06–0.11; p < 0.001). Between days 7 and 27, every 10 kcal/kg/d increase in energy intake was associated with a reduced risk of BPD of 9% (95% CI 1–16; p = 0.029) and any grade of ROP with a reduced risk of 6% (95% CI 2–9; p = 0.005) in multivariable models. This association was statistically significant in infants with ≤10 days of mechanical ventilation. In infants with >10 days of mechanical ventilation, a combined higher intake of energy and protein was associated with a reduced risk of BPD.

Conclusion: Early provision of energy and protein may reduce postnatal weight loss and risk of morbidity in extremely preterm infants.

Place, publisher, year, edition, pages
Elsevier, 2019. Vol. 38, no 3, p. 1289-1295
Keywords [en]
Extremely preterm infant, Nutrition, Growth, Retinopathy of prematurity, Bronchopulmonary dysplasia
National Category
Pediatrics Nutrition and Dietetics
Research subject
Pediatrics
Identifiers
URN: urn:nbn:se:umu:diva-147966DOI: 10.1016/j.clnu.2018.05.012ISI: 000469891800037PubMedID: 29885776OAI: oai:DiVA.org:umu-147966DiVA, id: diva2:1209502
Funder
Stockholm County CouncilAvailable from: 2018-05-23 Created: 2018-05-23 Last updated: 2019-06-24Bibliographically approved

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Stoltz Sjöström, ElisabethDomellöf, Magnus

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