Nutrition practice, compliance to guidelines and postnatal growth in moderately premature babies: the NUTRIQUAL French survey

BMC Pediatrics

Francesco Bonsante²  Jean-Bernard Gouyon²  Pierre-Yves Robillard²  Alexandre Lapillonne¹  Marianne Viaud²  Silvia Iacobelli² 

[1] Paris Descartes University, Paris, France;Néonatologie, Réanimation Néonatale et Pédiatrique, CHU La Réunion - Saint Pierre, Saint Pierre Cedex BP 350 97448, France

关键词: Parenteral and enteral intake;    Growth retard;    Standards;    Calories;    Feeding;    Survey;    Newborn;   

Others  :  1224641
DOI  :  10.1186/s12887-015-0426-4

 received in 2015-04-07, accepted in 2015-08-20,  发布年份 2015

【 摘 要 】

Background

The nutritional care provided to moderately premature babies is poorly studied. For a large cohort of such babies, we aimed to describe: nutrition practice intentions, comparison of the intended with the actual practice, compliance of actual practice to current nutrition guidelines, and postnatal growth.

Methods

A questionnaire was sent out to 29 neonatal intensive care units in France, in order to address practice intentions. In the same units, retrospective patient’s data were collected to assess actual practice, compliance to nutrition guidelines and infant postnatal growth. The cumulative nutritional deficit during the two first weeks of life was calculated and variables associated with ΔZ-score for weight at 36 weeks postconceptional age/discharge (ΔZ-score _w36PCA/DC) were analysed by multivariate linear regression.

Results

276 infants born 30 to 33 weeks of gestation were studied. Among them, 76 % received parenteral nutrition on central venous line after birth. On day of life 1 (DOL1), 93 % of infants had parenteral amino acids (AA), at an intake ≥ 1.5 g/kg in 27 % of cases. Lipids were started at ≤ DOL2 in 47 % of infants. There was a divergence between the intended and the actual practice for both AA and lipids intake. The AA and energy cumulative deficit (DOL1 to DOL14) were respectively 10.9 ± 8.3 g/kg and 483 ± 181 kcal/kg. Weight Z-score (mean ± SD) significantly decreased from birth (−0.17 ± 0.88) to 36 weeks PCA/DC (−1.00 ± 0.82) (p < 0.0001), and the extra-uterine growth retardation (EUGR) rate at 36 weeks PCA/DC was 24.2 %. Independent variables associated with ΔZ-score _w36PCA/DC were AA cumulative intake and DOL of full enteral feeding.

Conclusions

Nutrition intake was not in compliance with recommendations, and the rate of EUGR was considerable in this cohort. Efforts are needed to improve adherence to nutrition guidelines and growth outcome of moderately preterm infants.

【 授权许可】

   
2015 Iacobelli et al.

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