Early nutrition of very low birth weight infants and its effects on biomarkers of nutrition and infant growth
Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
We sought to evaluate the effects of changed nutritional regimens on nutritional intakes and growth on VLBW (<1500g) infants born extremely preterm (<27g.w). We also wanted to evaluate the correlation between nutrient intake and biomarkers of nutrition.
All parenteral and enteral intake were collected by chart review daily for the first 28 days of life and then weekly. Growth data and nutritional biomarkers were collected for the entire period until discharge. Data was also obtained from a different cohort (the EXPRESS cohort, 2004-2007) for which similar data was already collected. Univariate analyses were performed on growth and each of the nutrients chosen and compared between the 2004-2007 and 2010-2011 cohorts. Multivariate analysis was performed on growth data to exclude known confounders. The relationship between nutrient intake and biomarkers of nutrition was analyzed using regression analyses.
Significant improvements between the cohorts were seen during the first week for all nutritional parameters including fluid, energy and macronutrients. The same trend was seen during the first four weeks. Significant differences were also seen for weight z score change for the first week and when corrected for known confounders also in the first four weeks of high significance. Significant correlations between protein intake and the blood urea nitrogen (BUN) levels were observed during the first and second week and for the whole period combined. Between serum sodium levels and sodium or fluid intake no significant correlation was observed.
Improved nutrition routines with clear targets provide an improved nutritional intake closer to recommended levels. This in turn has a positive effect on the growth in terms of weight z score change. BUN is a validated means of assessing protein intake, while the s-sodium should be evaluated further.
Place, publisher, year, edition, pages
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:umu:diva-58095OAI: oai:DiVA.org:umu-58095DiVA: diva2:546778
Västerbottens läns landsting och Nutrium AB