Objective To investigate the energy and nutrients intake as well as physical development,and to explore the characteristics of the energy and nutrients intake,and their relationships with the weight gain in preterm infants at the early period of life. Methods Clinical data of 141 preterm infants were collected,who were hospitalized in the Department of Neonatology in the First Affiliated Hospital of Shantou University Medical College from January 2014 to January 2016 and were followed up for 3 months.The time for weight reaching to the birth weight and the caloric intakes reached to the reference dietary intakes (RDIs) were collected.The velocity of weight gain was calculated.The rate of intrauterine growth retardation (IUGR) and extrauterine growth retardation (EUGR) were recorded.And the weight gain and incidence of EUGR were compared between preterm infants with gestational age (GA)＜34 weeks and ≥34 weeks.The feeding status and the weight,length and head circumference were recorded after discharge. Results 1) The median days of weight reaching to the birth weight were 13.2 days.The median velocity of weight gain after reaching to birth weight was 16.7g/(kg·d).The median days of caloric intakes reaching to the RDIs were 10.6 days.2) The incidence of EUGR at discharge was higher than that of IUGR during at birth (46.1% vs.17.7%, P<0.01).The incidence of EUGR at discharge in infants with GA＜34 weeks was significantly higher than that in infants with GA≥34 weeks(P<0.05).3) The incidence of EUGR between preterm infants before and after 34 weeks of GA in 141 preterm infants at the third month after discharge was not significantly different from that during hospitalization (χ2=0.05,P>0.05). The incidence of EUGR was lower in preterm infants fed by breast milk combined with human milk fortifier (HMF) or post-discharge formula(PDF) (P＜0.05).The difference on the incidence of EUGR between preterm infants before and after 34 weeks of GA in the third month after discharge was not significant (χ2=2.75,P>0.05). Conclusions Preterm infants,especially those with lower GA,are easier to suffer from EUGR and it is difficult to be solved during a short period after discharge.If the preterm infants are fed by breast milk combined with HMF or PDF,the EUGR might be improved.
Key words
infant /
preterm /
nutrition /
weight /
extrauterine growth retardation
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References
[1] Fenton TR,Kim JH.A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants[J].BMC Pediatrics,2013,13(1):59-71
[2] 首都儿科研究所,九市儿童体格发育调查协作组.中国七岁以下儿童体重、身长身高和头围的生长标准值及标准化生长曲线[J].中华儿科杂志,2009,47(3):173-178
[3] 《中华儿科杂志》编辑委员会,中华医学会儿科学分会新生儿学组,中华医学会儿科学分会儿童保健学组.早产儿/低出生体重儿喂养建议[J].中华儿科杂志,2009,47(7): 508-510.
[4] 中华医学会肠外肠内营养学分会儿科协作组,中华医学会儿科学分会新生儿学组,中华医学会小儿外科学分会新生儿学组.中国新生儿营养支持临床应用指南[J].临床儿科杂志,2013,31(12): 1177-1182.
[5] Cleminson JS,Zalewski SP,Embleton ND.Nutrition in the preterm infant: what′s new?[J].Curr Opin Clin Nutr Metab Care,2016,19(3):220-225.
[6] Ofek Shlomai N,Reichman B,Lerner-Geva L,et al.Population-based study shows improved postnatal growth in preterm very-low-birthweight infants between 1995 and 2010[J].Acta Paediatr,2014,103(5):498-503.
[7] Clark RH,Thomas P,Peabody J.Extrauterine growth restriction remains a serious problem in prematurely born neonates[J].Pediatrics,2003,111(5Pt1):986-990.
[8] 早产儿营养调查协作组.新生儿重症监护病房中早产儿营养相关状况多中心调查例报告[J].中华儿科杂志,2009,47(1):12-17.
[9] Koletzko B.Pediatric nutrition in practice[M].Basel: Karger,2008,27-30.
[10] Regan FM,Cutfield WS,Jefferies C,et al.The impact of early nutrition in premature infants on later childhood insulin sensitivity and growth[J].Pediatrics,2006,118(5):1943-1949.
[11] Embleton ND,Simmer K.Practice of parenteral nutrition in VLBW and ELBW infants[J].World Rev Nutr Diet,2014,110:177-189.
[12] Boo NY,Soon CC,Lye MS.Risk factors associated with feed intolerance in very low birth weight infants following initiation of enteral feeds during the first 72 hours of life[J].J Trop Pediatr,2000,46(5):272-277.
[13] Biasini A,Monti F,Laguardia MC,et al.High protein intake in humanmaternal milk fortification for ≤1250 gr infants: intrahospital growth and neurodevelopmental outcome at two years[J].Acta Biomed,2018,88(4):470-476.
[14] Krcho P,Vojtova V,Benesova M.Analysis of human milk composition after preterm delivery with and without fortification[J].Matern Child Health J,2015,19(8):1657-1661.
[15] Bloom BT,Mulligan J,Arnold C,et al.Improving growth of very low birth weight infants in the first 28 days[J].Pediatrics,2003,112(1Pt1):8-14.
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