Abstract
Background: It is unclear if special feeding guidelines are necessary for SGA infants and if the extent of intrauterine growth retardation (IUGR) should be considered an important factor in decisions about their enteral nutrition. We conducted a retrospective cohort study to evaluate whether IUGR (birth weight and/or length at least 1.28 standard deviations (SD) below the mean for gestational age) was independently associated with early feeding intolerance in VLBW infants
Methods: All infants admitted during 2000–2003 to our NICU who lived for at least 28 days were included in the study if they had BW ≤1500 g and no major congenital anomalies. They were fed following a standardized protocol beginning within 48 hours of age with ≤20 ml/kg daily increments. Feeding tolerance was assessed as the age at which full enteral feeds (150 mL/kg/d) were achieved. Multiple regression analysis was used to identify factors that might influence early feeding tolerance during hospitalization
Results: 78 SGA and 143 AGA infants met the inclusion criteria. SGA infants had a similar BW (1188±246 vs 1138±227 g), higher GA (31.7±1.7 vs 28.6±1.8 wks; p<0.001), lower birth Z scores (ZsW -1.65±0.64 vs -0.06±0.74, ZsHC-1.54±0.74 vs -0.16±0.67, ZsL -1.82±0.89 vs -0.13±0.65; p <0.0001) and lower CRIB score (1.0±1.7 vs 2.6±2.9; p <0.0001) than AGA infants. Thirty-nine (50%) SGA infants had all the 3 Zscores <-1.28 SD (Symmetric SGA) and 20 (16.7%) had 2 Zscores <-2 SD (Severe SGA). SGA infants reached full enteral feeding earlier than AGA infants (19.8±10.1 vs 24.9±12.2 days of life; p = 0.018) and showed shorter time to achieve full feeds after initiation of milk feeds (17.0±9.0 vs 21.4±11.8 days; p =0.046). No difference was found in percentage of human milk intake from the beginning of milk feeding until full enteral feeds were achieved (59.4±32.2 vs 52.6±31.8%). When confounding variables were controlled in a multivariate regression model (r2 0.52), Zscores at birth and simmetric or severe IUGR were not significantly associated with the age of full enteral feeds; independent predictors were GA (coeff -3.6, p <0.0001), CRIB score (coeff 0.65, p =0.026) and percentage of human milk intake (coeff -0.44, p =0.017)
Conclusion: In our population IUGR did not influenced early feeding tolerance of VLBW infants
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Maggio, L., Gallini, F., Cota, F. et al. 169 Early Feeding Tolerance in Very Low Birth Weight Infants with Intrauterine Growth Retardation. Pediatr Res 56, 492 (2004). https://doi.org/10.1203/00006450-200409000-00192
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DOI: https://doi.org/10.1203/00006450-200409000-00192