Effect of aggressive nutritional support on preterm infants during hospitalization

Abstract

To explore the effect of aggressive nutritional support in early life on growth of preterm infants during hospitalization. Two retrospective cohorts of preterm infants were compared; 81 infants of group A (born between January 1, 2005 and June 30, 2006) and 79 infants of group B (June 1, 2009 and November 30, 2010) with gestational age above 28 weeks and birth weight between 1000 g and 2000 g, transfered to NICU of PUMCH within 12 hours after birth, hospitalized for > or = 2 weeks, who were free of major congenital anomalies and survived to discharge were recruited. The comparison of enteral and parenteral nutrition, growth rate, biochemical indices during hospitalization between these both groups were made. Compared to group A, group B was given greater volume of amino acid infusion on the 3(rd) and 7(th) day of life [2.00 (2.00, 2.50) g/kg vs 1.50 (1.50, 2.00) g/kg, 3.00 (2.00, 3.00) g/kg vs 2.00 (1.80, 2.60) g/kg, all P < 0.001], and Consumed more milk and total energy intake on the 3rd day of life [9.41(2.66, 18.74) ml/kg vs 14.47 (4.23, 30.77) ml/kg, P < 0.05, (64.87 ± 16.04) kcal/kg vs (55.62 ± 17.68) kcal/kg, P = 0.001]. Total energy intakes after a week of life were similar between the two groups. More infants received human milk fortifier in group B (62.8% vs 14.3%, P = 0.001). After stratification according to weight, both very low birth weight infants and infants with birth weight between 1500 g and 2000 g in group B grew more rapidly (P < 0.001). The percentage of growth retardation was increased after hospitalization in group A (65.4% vs 40.7%, P < 0.05), there were no statistically significant differences in group B. The mean Z scores at birth were comparable. The mean Z scores by discharge were higher in group B (-1.24 vs -1.54, P < 0.05). Serum albumin, prealbumin and urea values were similar in both groups at birth, but higher in group B after two weeks of life (P < 0.001). Before discharge, Serum albumin, prealbumin, and urea values in group B was higher (P < 0.001). Improvements in nutritional practices in early life of preterm infants effectively enhanced the growth and improved the nutritional status of preterm infants during hospitalization.