Objective: To assess the incidence of extrauterine growth restriction (EUGR) in very low-birth-weight infants (VLBWIs) and evaluate the nutrition factors in VLBWIs associated with inadequate nutrient intakes during hospitalization.
Methods: A total of 128 VLBWIs were divided into an EUGR group (n = 87) and a non-EUGR group (n = 41). Growth and parenteral nutrition (PN) and enteral nutrition (EN) practices were analyzed. Actual energy and protein intakes were subtracted from recommended energy (120 kcal/kg/d) and protein (3.75 g/kg/d) intakes, and nutrition deficits were calculated.
Results: Growth restriction was 21.9% at birth and 68.0% at discharge. Compared with established guidelines, PN was started late, and the maximum amino acid intake was low in both groups. EN interruption rate was higher in the EUGR group. The average energy intake in the first day after PN termination was lower in the EUGR group. There were significant differences in actual energy and protein intakes in the 2 groups for several weeks during hospitalization. The cumulative energy and protein deficits were significantly higher in the first 8 weeks and during the third to seventh weeks in the EUGR group, respectively. Step regression analysis showed that there was a significant negative correlation between the cumulative deficit of energy and changes of weight z-scores (r = -0.001, P < .05): as the energy deficit loss increased by 100 kcal, the weight z-scores dropped by 0.1 SD.
Conclusion: Inadequate nutrition intake aggravated the occurrence of EUGR in VLBWIs, especially the energy intake.
Keywords: enteral nutrition; extrauterine growth restriction; growth; infant; nutrition support; parenteral nutrition; very low birth weight infant.
© 2018 The Authors. Nutrition in Clinical Practice published by Wiley Periodicals, Inc. on behalf of American Society for Parenteral and Enteral Nutrition.