Nutritional Screening of Sick Neonates in NICU and Its Relation to Short Term Outcome

Abstract

Background Malnutrition during infancy has long-term physical and psychological adverse effect on development. Neonatal nutritional assessment is important to determine the daily energy and nutritional requirements needed for optimum growth and development. Objectives Assessment of the validity of Nutrition risk screening tools, and to stratify neonates admitted to the NICU according to their nutritional risk and correlate this to their outcome. Methods A cross-sectional study was conducted in NICU at Ain Shams University Hospitals. All neonates admitted to the NICU in a set period of 6 months from December 2017 to June 2018 were enrolled in the study after written and verbal consents were taken from parents.All neonates were subjected to the following: Anthropometric measurements (weight, length, head circumference, mid arm circumference, skin fold thickness and ponderal index at admission), Dietary assessment and laboratory investigations. The number of patients at this study were classified according to ‘Ohio neonatal nutrition screening tool (NNST) into a three risk groups: •low risk group: no = 121 •moderate risk: no = 15 •High risk: no = 14 Results The study showed that full intake enteral nutrition was reached in 100% of low and moderate risk groups and in only 64.3% of high risk group. Continuous parenteral nutrition was required in 100% of moderate and high risk groups and in only 7.4% of the low risk group. It also showed that the length of hospital stay was increased in the moderate risk group to 22 days (16-26) and in the high risk group to 8.5 days (3-16) while in the low risk group was only 5 days (4-7).Considering the hospital discharged patients: 100% of the moderate risk group, 99.2% of the low risk group and only 21.4% of the high risk group were discharged. According to the septic score, sepsis was recorded in 85.7% in the high risk group, 66.7% in the moderate risk group and only in 24% of the low risk group. Conclusion Nutritional screening tools were able to identify neonates at nutritional risk, as it showed that High risk group patients had higher rate of mortality and higher risk of Sepsis and thus they were in need for further assessment and support by nutrition specialist.