Nutrition profile of very low birth weight infants with extrauterine growth restriction in NICU

Abstract

Background & aims: Extrauterine growth restriction (EUGR) is associated with long-term complications such as neurodevelopmental dysplasia, increased mortality, and chronic metabolic disease. The incidence of EUGR in very low birth weight infants (VLBWIs) is generally high. This study's objectives were to (1) evaluate the nutritional support of VLBWIs with EUGR in our hospital NICU in the past 2 y and (2) provide guidance for improving clinical practice.

Methods: Preterm infants (birth weight < 1500 g) admitted to our hospital from February 2017 to July 2019 were enrolled in the study. Nutrient intakes were recorded daily, and growth parameters were regularly measured. Based on whether the infants reached the 10th percentile of the 2013 Fenton growth curve at discharge, the infants were divided into a EUGR group (n = 134) and a non-EUGR group (n = 34) and their nutrition support were compared with current ESPGHAN guidelines.

Results: A total of 138 VLBWIs were enrolled in the study. Growth restriction was 18.1% at birth and 75.4% at discharge for weight. Enteral nutrition (EN) was initiated late compared with the guidelines. The cumulative EN interruption time was long, especially in the EUGR group. Insufficient energy and amino acid intakes were prevalent, and cumulative energy and amino acid deficits failed to be compensated at discharge. Lower Z-score at birth (OR = 0.055, 95% CI = 0.018-0.172, p < 0.001) and long cumulative interruption time (OR = 1.058, 95% CI = 1.001-1.119, p = 0.046) were risk factors for EUGR incidence.

Conclusion: In general, the nutritional support for VLBWIs was inadequate, conservative enteral feeding was the main reason.

Keywords: Enteral nutrition; Extrauterine growth restriction; Parenteral nutrition; Very low birth weight infants.