Low energy intake during the first 4 weeks of life increases the risk for severe retinopathy of prematurity in extremely preterm infants
2016 (English)In: Archives of Disease in Childhood: Fetal and Neonatal Edition, ISSN 1359-2998, E-ISSN 1468-2052, Vol. 101, no 2, F108-F113 p.Article in journal (Refereed) Published
Objectives: Poor weight gain during the first weeks of life in preterm infants is closely associated with the risk of developing retinopathy of prematurity (ROP) and insufficient nutrition might be an important contributing factor. This study aimed to evaluate the effect of energy and macronutrient intakes during the first four weeks of life on the risk for severe ROP.
Study design: Population-based study including all Swedish extremely preterm infants born before 27 gestational weeks during a 3-year period. Each infant was classified according to the maximum stage of ROP in either eye as assessed prospectively until full retinal vascularization. Detailed daily data of actual intakes of enteral and parenteral nutrition as well as growth data were obtained from hospital records.
Results: Of the included 498 infants, 172 (34.5 %) had severe ROP (stages 3-5) and 96 (19.3 %) were treated. Energy and macronutrient intakes were less than recommended and the infants showed severe postnatal growth failure. Higher intakes of energy, fat and carbohydrates, but not protein, were significantly associated with a lower risk of severe ROP. Adjusting for morbidity, an increased energy intake of 10kcal/kg/d was associated with a 24 % decrease in severe ROP (p<0.01).
Conclusions: We showed that energy intake during the first four weeks of life was an independent risk factor for severe ROP. This implies that provision of adequate energy from parenteral and enteral sources during the first four weeks of life may be an effective method for reducing the risk of severe ROP in extremely preterm infants.
Place, publisher, year, edition, pages
2016. Vol. 101, no 2, F108-F113 p.
Growth failure, Macronutrients, Malnutrition, Nutritional intakes, Preterm infants
Nutrition and Dietetics Pediatrics
Research subject Pediatrics
IdentifiersURN: urn:nbn:se:umu:diva-88459DOI: 10.1136/archdischild-2014-306816ISI: 000371325900005OAI: oai:DiVA.org:umu-88459DiVA: diva2:715730